• 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.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.570-576
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• 2018

Background/Aims Swallows with viscous or solid boluses in different body positions alter esophageal manometry patterns. Limitations of previous studies include lack of standardized viscous substrates and the need for chewing prior to swallowing solid boluses. We hypothesize that high-resolution impedance manometry (HRiM) using standardized viscous and super-viscous swallows in supine and upright positions improves sensitivity for detecting esophageal motility abnormalities when compared with traditional saline swallows. To establish normative values for these novel substrates, we recruited healthy volunteers and performed HRiM. Methods Standardized viscous and super-viscous substrates were prepared using "Thick-It" food thickener and a rotational viscometer. All swallows were administered in 5-mL increments in both supine and upright positions. HRiM metrics and impedance (bolus transit) were calculated. We used a paired two-tailed t test to compare all metrics by position and substrate. Results The 5-g, 7-g, and 10-g substrates measured 5000, 36 200, and 64 $700mPa{\cdot}sec$, respectively. In 18 volunteers, we observed that the integrated relaxation pressure was lower when upright than when supine for all substrates (P < 0.01). The 10-g substrate significantly increased integrated relaxation pressure when compared to saline in the supine position (P < 0.01). Substrates and positions also affected distal contractile integral, distal latency, and impedance values. Conclusions We examined HRiM values using novel standardized viscous and super-viscous substrates in healthy subjects for both supine and upright positions. We found that viscosity and position affected HRiM Chicago metrics and have potential to increase the sensitivity of esophageal manometry.

• Anatomy and Cell Biology
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• v.56 no.3
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• pp.374-381
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• 2023

Although the epiglottis plays a vital role in deglutition, histological studies of the epiglottis and surrounding ligaments associated with swallowing dysfunction are limited. Therefore, we performed histological observations to clarify age-related changes in the morphological characteristics of the epiglottis and surrounding structures. Tissue samples comprising the epiglottis and surrounding structures were collected from corpses that were both orally fed and tubefed during their lifetimes. Following hematoxylin and eosin, Elastica Van Gieson, and immunohistochemical staining procedures, the chondrocytes, connective tissue, and glandular tissue were observed under the epiglottis epithelium, and intervening adipose tissue was observed in the surrounding area. Fatty degeneration of acinar cells was also observed in the glandular tissue, possibly because of aging. Bundles of elastic fibers were present around the vascular wall in the peri-epiglottic ligament, but some were reduced. Furthermore, large amounts of collagen fibers ran toward and through the cartilage, whereas the mesh-like elastic fibers stopped in front of the cartilage. Microfibrils considered to be oxytalan fibers, which are thinner and shorter than elastic fibers, were observed around the vascular wall and in the fiber bundles. Age-related changes included connective tissue fibrosis shown by the large amount of collagen fibers, atrophy of salivary glands, and an accompanying increase in adipose tissue. Regarding stretchability and elasticity, the elastic fibers may have an auxiliary function for laryngeal elevation during deglutition. This suggests that disuse atrophy of the laryngeal organs with or without oral intake might reduce the amount of elastic fiber in older adults.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.121-130
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• 1993

Mandibular rest position is very essential position because in that position, masticatory muscularture can be reciprocally coordinative and unstrained. So obtaining a good ability to establish and maintain rest position in non-functioning state is mandatory for treatment of patient with craniomandibular disorders. In general, many types of mandibulr movement exercise start from rest position and use the sense of muscle relearning, that is, muscle smoothness and relaxation, throughout the exercise period. In this study, 44 normal subjects for control group and 37 patients with craniomandibular disorders for experimental group participated and they were classified into 3 subgroups, respectively. One method to guide mandibular rest position was used for one subgroup, so theree methods were used for this study, 1)self-guided rest position without any education, 2) guided by Rocabado's tongue rest position, 3) guided through swallowing after Dawson's centric relation. To record electromyographic activity, Bioelectric processor EM2 (Myotronics, U.S.A.) was used. The numbers of sessions from start to stable resting electromyographic level and muscle activities in stable state were recorded and two recordings which were first and second, 3 days after first recording, were done, The data were processed with SPSS/PC+package. The obtained results were as follows : 1. Mean number of sessions in second recording were fewer than those in first recording in both groups. In comparison among 3 subgroups, mean number of sessions of subgroup guided through Dawson's method were fewer than those of other groups though it is not statistically significant. 2. There was a difference of mean number of sessions between control and experimental group in first recording, but in second recording there was no difference in any cases. 3. Mean value of muscle activity were generally not different without regard to group and method if once come to stable resting position level. Mean value of muscle activity of guided subgroups showed a tendency of decreasing in second recording than in first recording. However, in self-guided subgroup there was a inconsistent pattern. 4. The amounts of change in session number from first to second recording in control group were fewer than those in experimental group.

• Tuberculosis and Respiratory Diseases
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• v.64 no.1
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• pp.39-43
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• 2008

A hiccup is caused by involuntary, intermittent, and spasmodic contractions of the diaphragm and intercostal muscles. It starts with a sudden inspiration and ends with an abrupt closure of the glottis. Even though a hiccup is thought to develop through the hiccup reflex arc, its exact pathophysiology is still unclear. The etiologies include gastrointestinal disorders, respiratory abnormalities, psychogenic factors, toxic-metabolic disorders, central nervous system dysfunctions and irritation of the vagus and phrenic nerves. Most benign hiccups can be controlled by traditional empirical therapy such as breath holding and swallowing water. However, though rare, a persistent hiccup longer than 48 hours can lead to significant adverse effects including malnutrition, dehydration, insomnia, electrolyte imbalance, and cardiac arrhythmia. An intractable hiccup can sometimes even cause death. We herein describe a patient with non-small cell lung cancer who was severely distressed by a persistent hiccup.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.3
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• pp.327-333
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• 2016

Tourette's syndrome is a chronic neuropsychiatric disorder characterized by the presence of vocal and multiple motor tics. Tics are defined as brief, intermittent, repetitive, unpredictable, purposeless, and stereotyped movements or sounds. Some patients experience physical pain from intense and complex tics. In addition, motor tics can result in self-injury which is a common feature of Tourette's syndrome. A 9-year-old boy was referred by the department of neuropsychiatry because of a severe tongue laceration. His parents reported that he had been biting his tongue irregularly for 2 months before referral and suffered from an intense burning sensation. The repeated biting resulted in ulcers on the tongue, which quickly worsened and led to progressive difficulty chewing and swallowing food. We offered to give him a two-piece removable appliance to limit tongue biting; it was made of soft silicone and fitted to both the maxillary and mandibular arches. As we emphasized that the device could help alleviate his pain, he agreed to accept it and adapted well. Just 3 weeks later, his tongue lesions had healed significantly.

• Journal of Oral Medicine and Pain
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• v.34 no.4
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• pp.421-427
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• 2009

Oromandibular dystonia is a focal neurological movement disorder characterized by involuntary sustained and often painful muscle contraction, usually producing repetitive movements or abnormal positions of the mouth, jaw and.or tongue. Patients suffering from oromandibular dystonia often experience difficulties in chewing, swallowing and speaking, resulting from the impairment of mandibular movements. At present there is no etiologic treatment for oromandibular dystonia, because the pathophysiology of primary and focal dystonia is still incompletely understood. Many treatments such as medication, behavioral therapy, surgery are suggested to decrease the involuntary movements. But these success rates are relatively low and they have a lot of complications. many studies suggested that chemodenervation with botulinum toxin is the most effective treatment for oromandibular dystonia. We reported the 2 cases which were treated oromandibular dystonia with botulinum toxin and reviewed the orofacial movement disorders(especially oromandibular dystonia) and botulinum toxin treatment for oromanfibular dystonia.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.50-54
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• 2019

Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.263-275
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• 2022

The loss of posterior occlusal support leads to further complications such as collapsed occlusal plane and reduced vertical dimension, and it may cause problems such as facial appearance change, reduced chewing efficiency, and temporomandibular joint disorders. In such case, it is necessary to re-establish occlusal plane and vertical dimension properly through accurate diagnosis and predictable treatment plan. This case report presents a 71-year-old female, whose occlusal plane was collapsed and posterior restorative space was insufficient. To perform a patient-friendly full mouth rehabilitation, proper vertical dimension and occlusal plane were decided by evaluation of interocclusal space at her physiologic mandibular rest position, swallowing, pronunciation, facial appearance, and the average length of anterior teeth. And then, the fixed provisional restorations were fabricated with the new occlusal position, and evaluated for 5 months with checking adaptation of masticatory muscles and any kind of clinical symptoms occurs or not. After confirmation of functional stability and esthetic satisfaction with the newly established occlusion, final definitive restorations were fabricated and inserted in the mouth. Through the above process, the treatment result was functionally and aesthetically satisfactory.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.55-68
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• 2022

Objective : This review aimed to provide information for clinical application by confirming the principles and characteristics of the tool through a review of tongue movement and measurement tools for patients with swallowing disorders. Results : We identified 15 tools used as tongue exercises and measurement tools in the field of dysphagia. According to principle, the tools were classified as either a bulb sensor, resistive sensor sheet, mouthpiece with sensor, or other techniques. The bulb sensor was easy to use but had limitations in fixing the position when measuring tongue pressure. The resistive sensor sheet could be measured at a more stable position than the bulb sensor. A mouthpiece with a sensor could be used in an individual's oral cavity such that the position was fixed when measuring the tongue pressure. Other techniques had the advantage of being wireless and capable of sensing light. Conclusion : Based on this literature review, it is necessary to facilitate the selection of the best tool for quantitative tongue measurement in dysphagia. The review can also be used to develop a Korean tongue movement tool model that can be used in hospitals and community centers.