• Title/Summary/Keyword: Swallowing disorders

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A Study of the Chewing Patterns in Patients with Temporomandibular Disorders by Electrognathography (Electrognathography를 이용한 측두하악장애환자의 저작양태에 관한 연구)

  • Moon-Gyu Kim;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • v.20 no.2
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    • pp.291-306
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    • 1995
  • Mandibular movement is composed of border movement and functional movement. Border movement such as maximal mouth opening, hinge opening ad lateral eccentric movement has good reproducibility, but functional movement such as chewing, swallowing and speech has also reproducibility. Especially for chewing movement, individual reproducibility has been confirmed by many studies. Study of chewing pattern is still in controversy. In new approach for raising the diagnostic value, numeric parameters and morphologic characteristics could be used for evaluation of chewing pattern. This study was performed to investigate the differences between chewing pattern in controls and in patients with temporomandibular disorders. Sixty-three patients with temporomandibular disorders participated in this study, and they were divided into unilaterally affected subjects or bilaterally affected subjects. Then unilaterally affected subjects were classified into closed lock group, disk displacement with reduction group, and degenerative joint disease group. For recording of chewing pattern, subjects were asked to chew one piece of presoftened chewing gum on both sides, and the chewing movement was recorded with the Electrognatho- Graphy(Bio-Research Associates Inc., U.S.A.). Tooth contact pattern for occlusal stability (Total left-right statistics )was also recorded with T-Scan(Tekscan Co., U.S.A.). The dta related to chewing pattern and total left-right statistics were statistically analyzed by SAS/stat program. The obtained results were as follows : 1. In patient group, mean value of A-P distance and the ratio of A-P distance to vertical distance were larger than control group, but the value of lateral distance in affected side and the closing velocity in unaffected side were smaller than that of control group, respectively. 2. In case of unilateral affected patients, chewing pattern of other side had tendency to restricted movement and slow velocity in closed lock group or degenerative joint disease group than control group or disk displacement with reduction group. 3. In bilateral degenerative joint disease patients, contralateral side had tendency to large range of motion and slow chewing velocity than preferred chewing side. 4. The patients with restricted mouth opening below than 35mm had higher value of total left-right statistics than patient group mouth opening above 35mm. Also closed lock group had higher total left-right statistics than disk displacement with reduction group, degenerative joint disease group and control group. 5. There was some difference in morphologic characteristics of chewing pattern between in control group and in affected side of unilateral patient group, but no difference between control group and unaffected side of unilateral patient group. 6. There were positive correlations between vertical distance and A-P distance, between vertical distance and chewing velocity, between A-P distance and chewing velocity, and between opening velocity and closing velocity in unilateral affected patients.

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Dysphagia Rehabilitation Treatment for Children With Feeding Disorder : A Systemic Review (섭식장애가 있는 아동의 연하재활치료 : 체계적 고찰)

  • Jeon, Joo Young;Park, Hae Yean
    • The Journal of Korean Academy of Sensory Integration
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    • v.19 no.1
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    • pp.39-53
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    • 2021
  • Objective : The purpose of this study was to systematically review dysphagia rehabilitation treatment for children with feeding disorders. Methods : The articles evaluated in this study were collected from the PubMed, Medline Complete, and CINAHL databases and subsequently reviewed using the PRISMA flow chart and PICOS approach. A total of 13 papers were analyzed for study quality, disease groups, evaluation tools, interventions, and post-intervention effects. Results : Of the reviewed papers, six (46.15%) related to autism spectrum disorder (ASD) and seven (53.85%) to cerebral palsy (CP) with age ranges of between 2 and 8 years for the ASD studies and between 12 months and 18 years for CP. In evaluating the types of feeding disorder involved, the ASD group exhibited predominantly behavioral conditions while the CP subjects had a larger number of functional oral and swallowing issues. In terms of interventions, behavior modifications were used most frequently with ASD while oral-sensory motor, texture modifications, and electrical stimulation were applied at the same frequency with children with CP. All interventions were found to be effective. Conclusion : In this study, research into children with feeding disorders was reviewed according to condition, evaluation tool, and method of intervention. It is expected that this review can be used as basic data for developing a protocol that will allow clinicians to efficiently apply condition-specific interventions for eating disorders without resorting to trial and error.

A Case of Trichobezoar in a Child Who Visited with Intermittent Abdominal Pain, Nausea and Vomiting (간헐적 복통과 오심, 구토로 내원한 Trichobezoar 1례)

  • Ahn, Seung-In;Yoo, Jung-Suk;Oh, Kyung-Chang;Kim, Bong-Lim;Kim, Sung-Sup;Kim, Yeun-Ho;Chang, Jin-Keun
    • Clinical and Experimental Pediatrics
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    • v.48 no.4
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    • pp.433-437
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    • 2005
  • Bezoars are concretions commonly found in the stomach and small bowel, and four types of bezoars have been described based on their composition : trichobezoar, phytobezoar, lactorbezoar, and miscellaneous. Bezoars most often develop after gastric operations that alter the motility, emptying, and grinding of food in the stomach. Trichobezoars are most common in female children with normal gastrointestinal function and are usually associated with pica, mental retardation, and psychiatric disorders. Although uncommon, bezoars are a well-recognized cause of chronic abdominal complaints which, when undiagnosed, can result in serious complications including gastric ulceration, bleeding, perforation, intussusception and small bowel obstruction. Mortality rates of up to 30 percent have been reported in adults. Trichotillomania is behaviors surrounding hair-pulling, including stroking and playing with hair before pulling, or biting and swallowing the hair after it has been pulled(trichophagia). The most notorious of the medical sequelae of trichotillomania is the trichobezoar. We experienced a case of trichobezoar in an 11-year-old girl who frequently swallowed her hairs from age 4 years up to age 7 years, resulting in intermittent abdominal pain, nausea, and vomiting.

Development and Evaluation of a Dysphagia Assessment Tool and an Intervention Program for the Elderly in the Long-Term Care Facilities (노인요양시설 노인의 연하곤란 사정도구, 중재프로그램 개발 및 평가)

  • Kim, Chi-Young;Lee, Young-Mi;Ha, Eun-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.2
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    • pp.685-693
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    • 2012
  • The purpose of this study was to develop a dysphagia assessment tool and a intervention program for elderly in the long-term care facilities and to evaluate its effect. The dysphagia assessment tool consists of 20 items was developed through literature review, previous studies and discussion with nursing/medical members. The intervention program consisted of 72 items and participants for evaluation were 50 elders who were registered at long-term care facilities in 4 regions of Seoul. Collected data were analyzed using SPSS Statistics 18.0 and Spearman's Correlation, t-test, and $x^2$-test. After the application of the dysphagia assessment tool and intervention program, the weight in experimental group was increased (t=4.913, p=.000) and the total time of swallowing was reduced (t=-4.557, p=.000) than control group. These findings were statistically significant. Considering these results, by applying the dysphagia assessment tool and the intervention program, the lives of the elderly in long-term care facilities are expected to be improved and emergency situations such as aspiration pneumonia and asphyxia will be decreased.

Full mouth rehabilitation in a patient with partial mandibulectomy using CAD/CAM zirconia framework and monolithic zirconia (하악골 부분절제술 시행한 환자에서 CAD/CAM Zirconia Framework와 Monolithic Zirconia를 이용한 전악 수복 증례)

  • Ma, Bo-Young;Park, Hongju;Im, Yeong-Gwan;Park, Chan;Shin, Jin-Ho;Lim, Hyun-Pil
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.279-285
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    • 2017
  • Defects due to mandibulectomy often cause hard and soft tissue loss and result in esthetic problems and functional disorders such as mastication, swallowing, and pronunciation. After the mandibular reconstruction, several complications including loss of alveolar bone can cause limitations in maintenance or supporting of removable prosthesis. For these patients, implant-supported fixed restorations have been an appropriate prosthetic restorative method. In this case report, we report the patient who underwent mandibulectomy and mandibular reconstruction owing to oral cancer, and then restored the current dentition functionally and aesthetically by applying zirconia frameworks and monolithic zirconia crowns by computer-aided design and computer-aided manufacturing.

Effect of Body Posture on the Rest Position and the Rotational Torque Movement of the Mandible (신체 자세의 변화가 하악의 안정위와 비틀림 회전운동에 미치는 영향)

  • Jung, Seung-Ah;Han, Kyung-Soo;Park, Mi-Sung;Yang, Keun-Young
    • Journal of Oral Medicine and Pain
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    • v.25 no.4
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    • pp.383-394
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    • 2000
  • This study was performed to investigate the effect of change of body posture on the rest position and the rotational torque movement of the mandible. Thirty dental students without any signs and symptoms of temporomandibular disorders and with natural dentition were selected for this study. Cervical inclination and the amount of the mandibular movement on protrusion, on left and right excursion, and on tapping in three body postures such as sitting position, supine position without pillow, and supine position with pillow were measured by goniometer, Cervical-Range-of-$Motion^{(R)}$, and mandibular tracking device, $BioEGN^{(R)}$ with $Rotate!^{(R)}$ program. The data obtained were classified and processed according to body posture and type of lateral guidance with SPSS windows program and the results were as follows: 1. There was significant difference among the three cervical inclinations by body postures. 2. Comparison of mandibular rest positions among body postures showed significant difference only for lateral distance in frontal plane, but comparison between before and after swallowing showed significant difference except for the lateral distance, vice versa. 3. Distance and amount of the rotational torque movement on protrusion and/or lateral excursions didn't show any difference by body posture. But by both body posture and lateral guidance type, there were slightly significant difference for some items. 4. A significant difference was shown for the rotational torque movement in frontal plane on tapping by body postures, for the lateral distance in frontal plane on sitting position by lateral guidance type, and for the rotational torque movement in frontal plane by both body posture and lateral guidance type.

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A Case of Dihydropteridine Reductase Deficiency (Dihydropteridine Reductase 결핍증 1례)

  • Oh, Se-Jung;Hong, Yong-Hee;Lee, Yong-Wha;Lee, Seung-Tae;Ki, Chang-Seok;Lee, Dong-Hwan
    • Journal of Genetic Medicine
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    • v.6 no.2
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    • pp.170-174
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    • 2009
  • Tetrahydrobiopterin ($BH_4$) deficiency is caused by mutations in genes encoding enzymes involved in the synthesis and regeneration of $BH_4$. The condition is usually accompanied by hyperphenylalaninemia (HPA) and deficiency of neurotransmitter precursors L-dopa and 5-hydroxytryptophan. $BH_4$ deficiency is much rarer than classical phenylketonuria. Dihydropteridine reductase (DHPR) deficiency, an autosomal recessive genetic disorder, is a cause of malignant hyperphenylalaninemia due to $BH_4$ deficiency. When left untreated, DHPR deficiency leads to neurologic deterioration at the age of 4 or 5 months, including psychomotor retardation, tonicity disorders, drowsiness, irritability, abnormal movements, hyperthermia, hypersalivation, and difficulty swallowing. Treatment of DHPR deficiency should be initiated as early as possible with $BH_4$ supplementation and replacement of the neurotransmitter precursors L-dopa and 5-hydroxytryptophan. We report the first case of DHPR deficiency in Korea, a child diagnosed at 9 years of age by genetic testing.

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10 year follow up of a boy with Lesch Nyhan Syndrome

  • Kim, Sook Za;Song, Wung Ju
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.11 no.1
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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.

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The Effects of Pilocarpine in Patients with Orofacial Movement Disorder (구강안면운동장애에 대한 필로카핀의 적용)

  • Jeong, Sung-Hee;Ok, Soo-Min;Huh, Joon-Young;Ko, Myung-Yun;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.37 no.2
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    • pp.107-112
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    • 2012
  • Orofacial movement disorders (OMD) are uncontrolled movement of the muscles involving the face, tongue, lip and mandible. Due to variable oral and lingual muscles affected, the patients with OMD are interfered with the appropriate performance such as chewing, swallowing and talking. In this study, there are 4 OMD cases with oral dryness that saliva flow rate is decreased or not. The symptoms are improved after oral administration of pilocarpine to 4 patients with OMD. Therefore, we suggest that objective or subjective oral dryness could be etiologic factor in OMD and pilocarpine could be regarded as medication for OMD.

A Study on the Development of a Program to support VFSS by using Deeplearning (딥러닝을 활용한 VFSS를 도와주는 프로그램 개발 연구)

  • Choi, Dong-gyu;Jang, Jong-Wook
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.10a
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    • pp.58-61
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    • 2018
  • In Korea, current medical technology is the highest level in the world. As a result, many doctors have specialized knowledge of various disorders or diseases, and are proceeding in a better way. With such high medical technology, it is possible to increase the probability of success of surgery to provide high reliability to patients. Rehabilitation is also a form of medical treatment that reduces the side effects that occur after surgery that is done for quick cure. However, the situation in this section is slightly different. There are moves to develop rehabilitation devices and operations, but most of them are now dependent on foreign technology. Rehabilitation therapy, which we commonly know, is dominated by behavior. However, it is also a kind of rehabilitation to find out how much the patient's symptoms are improved or recovered. In this paper, we have studied the development of a program by using the Deeplearning method in order to detect the problem of the food swallowing operation by the severity.

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