• 한국산학기술학회논문지
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• 제15권5호
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• pp.2981-2988
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• 2014

본 연구는 삼킴장애 환자를 대상으로 한국판 SWAL-QOL의 신뢰도와 타당도를 알아보기 위해 실시되었다. 비디오 투시 영상을 통해 삼킴장애로 진단받은 환자 71명과 일반인 80명을 대상으로 하였다. 한국판 SWAL-QOL의 문항내적일치도는 Cronbach's $\alpha$ 값이 .86~.96이었고, 급간내상관계수는 .80~.93으로 신뢰도가 높았다. 한국판 SWAL-QOL의 각 척도간 상관관계를 알아본 결과 피어슨 상관계수는 .17~.74로 모든 척도간에 유의한 상관성을 보였다(p<.05). 삼킴장애군과 정상군간에 한국판 SWAL-QOL을 비교한 결과 모든 척도에서 정상군의 점수가 높았으며 두 그룹간에 유의미한 차이가 있는 것으로 나타났다(p<.01). 관 식이 그룹은 관 식이를 하지 않은 그룹에 비해 모든 척도에서 점수가 낮았으며 수면척도를 제외하고 모든 척도에서 유의한 차이가 있었다(p<.05). 식이단계에 따른 차이를 살펴보면 식이 4단계 환자의 점수가 가장 높았으며, 식사욕구, 의사소통, 두려움 척도를 제외한 모든 척도에서 식이 단계간에 통계적으로 유의한 차이가 있었다(p<.05). 따라서 한국판 SWAL-QOL는 신뢰도와 임상타당도가 높기 때문에 임상에서 삼킴장애 환자의 삶의 질을 측정하는 도구로 사용되는데 적절한 것으로 판단된다.

• 대한지역사회영양학회지
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• 제20권3호
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• pp.208-219
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• 2015

Objectives: According to preceding studies, many people with mental disability have unbalanced dietary habits or excessive intake of calories. Most of them are overweight or obese due to lack of self-control for food consumption, swallowing with inadequate chewing and physical inactivity. Therefore, this study aimed to assess the nutritional intake, including carotenoid, in mentally disabled people and find out a possible solution for nutritional improvement. Methods: People with intellectual disability (N=28), emotional disability (N=44) participated in this study. The disorder grades were from I to III and ages were between 20 and 65 years. Assessments included anthropometry, daily intake of nutrients, including carotenoid, ROMA III questionnaire for assessing bowel movement. Results: The average BMI of intellectually disabled people and emotionally disabled people was in the range of overweight and obesity respectively ($23.7{\pm}6.3kg/m^2$, $25.8{\pm}4.1kg/m^2$). Overall, the frequencies of vegetable and dairy product intakes were lower in this population. When compared with Recommended Nutrient Intake (RNI) from Dietary Reference Intakes for Koreans 2010, the intakes of vitamin $B_1$, vitamin $B_2$ and calcium were insufficient in both groups. Also, lycopene intakes of carotenoid were low, compared with traditional Korean diet of the non-disabled people from the second year 2008 of the 4th National Health and Nutrition Survey. In addition, emotionally disabled people also had lower intake of cryptoxanthin. Conclusions: The mentally disabled people in this study showed lower intakes of vitamin $B_1$, vitamin $B_2$, calcium and carotenoids. Based on these findings, we recommend that it is important to encourage mentally disabled people to consume sufficient amounts of such nutrients in order to promote nutritional status.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권3호
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• pp.259-266
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• 2005

The function of the masseter and anterior temporal muscles was assessed by electromyography in 30 patients with mandibular prognathism (20 patients with facial asymmetry and 10 patients without facial asymmetry) before orthognathic surgery and 4weeks afterwards. Electromyogram(EMG) recordings were made during resting, clenching and swallowing. We compared with right-left difference of this recording and asymmetry index before and after orthognathic surgery. The result of this study was as follows. 1. There was no significant right-left difference in muscle activities of masticatory muscles both asymmetric groups and controls and many variable change after orthognathic surgery.(P>0.05) 2. The mean electric activity of the masticatory muscles was found to have decreased during more clenching than resting, but there was no statistically significant difference because of individual difference of measuring values.(P>0.05) 3. The asymmetry index of masticatory muscles in asymmetric groups was significantly greater during clenching compared with controls.(P<0.05) In conclusion, no right-left difference of muscle activities was found in patients with facial asymmetry before orthognathic surgery and 4weeks afterwards. Not only muscular functioning but also many other factors, such as occlusion, temporomandibular joint disorder and trauma, probably affect facial asymmetry and will be analyzed in future studies. And we will need long term follow-up after orthognathic surgery.

• 한국산학기술학회논문지
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• 제13권4호
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• pp.1665-1671
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• 2012

이 연구는 뇌졸중으로 인한 삼킴장애 환자를 대상으로 반복된 경부근육전기자극치료(NMES) 과정에서 나타나는 음성의 변화를 음향음성학적 분석 방법으로 분석하고, NMES 중재가 음성에 미치는 영향을 파악하고자 하였다. 2010년 2월 부터 2011년 3월까지 인천광역시의 2개 병원에서 삼킴장애로 진단을 받은 발성이 가능한 15명의 남성을 대상으로 2개월 동안 반복된 경부근육전기자극치료를 실시하였다. 음성은 강도, 음도($F_0$), 음질(Jitter, Shimmer, NNE; Normalized Noise Energy)을 측정하였고, 중재가 종료된 1주 후에 변화된 음성이 유지되었는지를 분석하였다. 연구결과, NMES 중재 후 대상자의 삼킴 기능 회복과 함께 음성 강도가 향상되었고, 성대 진동의 주기성(Jitter, Shimmer)이 안정되었다(P<0.05). 그러나 음도는 유의한 차이가 없었고, NNE는 중재 후 향상되었지만 여전히 비정상적인 수치를 보였다. 이 결과는 반복된 경부근육전기자극치료가 삼킴 능력의 회복과 함께 음성 강도의 향상 및 성대 진동 주기성의 안정화에 영향을 미칠 수 있는 가능성을 시사한다.

• 대한치과보철학회지
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• 제56권2호
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• pp.161-165
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• 2018

본 증례는 2016년 점액표피양 암종으로 인해 종괴 제거 후 발음이 잘 되지 않는다는 주소로 연세대학교 치과대학병원 보철과로 의뢰 된 38세 여환으로, 구개 거상장치를 제작하고 연성 이장재를 사용하여 연구개를 거상시켜 발음 및 연하 개선 여부를 확인하였으며 최종적으로 열중합 레진으로 교체하였다. 이후 환자는 발음 및 연하에 있어 만족할만한 결과를 보였다. 따라서 본 증례를 보고하는 바이다.

• Journal of Genetic Medicine
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• 제6권2호
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• pp.170-174
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• 2009

저자들은 생후 3개월에 전형적인 페닐케톤뇨증으로 진단받고 식사요법을 유지하였으나 지연된 발달 소견 및 지능 저하를 보이고 경련 증상이 있었던 9세 남자 환아에서 효소 검사와 유전자분석으로 dihydropterine reductase (DHPR) 결핍증을 진단하였다. 그리고 $BH_4$, 신경전달물질 전구체 투여 및 엽산 보충으로 DHPR 결핍증을 치료한 1례를 경험하였기에 문헌고찰과 함께 보고한다.

• 대한장애인치과학회지
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• 제7권1호
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• 대한유전성대사질환학회지
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• 제11권1호
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• pp.88-98
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• 2011

Lesch-Nyhan syndrome is a X-linked recessive disorder caused by a deficiency of the enzyme hypoxanthine-guanidine phosphoribosyltransferase (HPRT), enzyme to recycle purines. Case history: born induced vaginal delivery at 40 weeks complicated by premature membrane ruputure, body weight 2.820 gm. He showed failure to thrive showing severe protein aversion like milk products and pink daper. Developmental delay revealing rolling over at 10.5 month, followed by regression. Seizure at 2 months, His poor oral feeding was lifelong problem. Weak crying, spastic, choreoathetoid movement. Self mutilating behavior noted and diagnosed at age 3 years. No family history of consanguinity and neurological disorders. Method: Laboratory test, physical exam, imaging study and molecular. Clinical follow up Treat ment with allopurinol. Result: uric acid 10.5 mg/dL (N 3.5-7.9), APRT 151.1uM/ min/ml pro(25.7-101), HPRT 7.6 (N 233.5-701) and c.151C>T hemizygote (p,Arg51X). Abdominal sonogram showed staghorn calculi in both kidneys, brain MRI brain atrophy. Clinical follow up showed, seizure at 2 mo, developmental delay (head control and, rolling over at at 11mo, pointing body part at 2 yr 7 mo, eye hand coordination at 2 y 11mo,creeping at 3 y 7 mo, speaking words at 6 y 6 mo ),and developmental regression at 3 yr of age. Sleeping problem including insomnia and severe constipation. Self mutilating behavior (lip bite) started at 2.5 yr, neurologic sx including intermittent upward gaze accompanied by swallowing difficulty at 3 y 7 mo grand mal seizure at 4.5 yr and spastic extremity and trunchal hypotonia and choleoathetoid movement and ataxia at 6.5 yr. Scoliosis with severe spasticity at 9 yr 9 mo. Acute life threatening episode with irregular breathing at 9 yr and 9 mo, Emaciation and nephrolithiasis and recurrent pneumonia. Died suddenly at 10 yr 3 mo. Conclusion: life long feeding problem, chronic gut motility dysfunction, sleeping difficulty and progressing neurologic deterioration and nephrolithiasis despite normal serum uric acid maintence by allopurinol treatment.

• 동의생리병리학회지
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• 제21권2호
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• pp.539-542
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• 2007

After analyzing the cases of treating female patients troubled with morbid leukorrhea, the writer drew the conclusions as follows. The shapes of patients with morbid leukorrhea show a large number of shapes of Gi type, Sin type or being inclined to be vigorous Gi, to have depressive syndrome due to disorder of Gi, to be Fire's nature flared upward, to become retention of phlegm and fluid, to become retention of Gi or to become retention of heat, or San syndromes. Accompanied syndromes of morbid leukorrhea appear over the body of upper, middle or lowe portion. In lower cho, the symptoms are menopathy, menstrual irregularities, menstrual irregularities, oligomenorrhea, itching of external genitals, San syndromes, infertility, lumbago which are connected with uterus. And in the middle cho, those are indigestion, nausea, distress in the stomach, vomiting, swallowing acid connected with digestive organs. And also in the upper cho, globus hystericus, chest distress, headache, dizziness, neck stiffness, heat in the upper, pimples connected with upper cho are appeared. Among the prescriptions of treatment for morbid leukorrhea, Ijintang was applied with the widest range of all. Besides that there were mainly prescribed for symptoms such as Gamisachil-tang, Haenggihyangso-san, Gamigwibi-tang, hyangsapyeongwi-san, Onkyung-tang, Banchong-san, Yongdamsagan-tang, Sogampaedok-san, Ojeok-etc.

• Tuberculosis and Respiratory Diseases
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• 제53권3호
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• pp.344-348
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• 2002

저자 등은 자리돔 가시를 먹고 흉부통증과 호흡곤란을 호소하여 내원한 환자에서 흉부전산화단층촬영에서 종격동염을 진단하고 보존적 치료에 의해 호전된 급성종격동염 1예를 경험 하였기에 문헌 고찰과 함께 보고하는 바이다.