• Title/Summary/Keyword: swallowing disorder

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Development and Evaluation of an Enteral Nutrition Protocol for Dysphagia in Patients with Acute Stroke (연하 곤란이 동반된 급성 뇌졸중 환자를 위한 장관 영양 프로토콜 개발 및 효과)

  • Yoo, Sung-Hee;Kim, So-Sun
    • Journal of Korean Academy of Nursing
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    • v.44 no.3
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    • pp.280-293
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    • 2014
  • Purpose: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. Methods: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. Results: In the EN protocol group, the percentage of caloric goals achieved ($R^2=.24$, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. Conclusion: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

Glossopharyngeal Neuralgia Caused by Arachnoid Cyst in the Cerebellopontine Angle

  • Cho, Tack-Geun;Nam, Taek-Kyun;Park, Seung-Won;Hwang, Sung-Nam
    • Journal of Korean Neurosurgical Society
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    • v.49 no.5
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    • pp.284-286
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    • 2011
  • Glossopharyngeal neuralgia is a relatively rare condition characterized by severe, paroxysmal episodes of lancinating pain in the tongue, throat, ear, and tonsil. This disorder is assumed to be due to compression of the glossopharyngeal nerve by vascular structures. A 47-year-old woman complaining of sharp and lancinating pain in the right periauricular and submandibular areas visited our hospital. Swallowing, chewing, and lying on her right side triggered the pain. Her neurologic examination revealed no specific abnormalities. The results of routine hematologic and blood chemistry studies were all within normal limits. Carbamazepine and gabapentin were given, but her symptoms persisted. Her pain was temporarily relieved only by narcotic pain medication. MRI showed an arachnoid cyst located in the right cerebellomedullary cistern extending to the cerebellopontine cistern. Cyst removal was performed via a right retrosigmoid approach. Lateral suboccipital craniotomy was performed using the right park-bench position. After opening the dura and cerebellopontine angle, the arachnoid cyst was exposed. The arachnoid cyst was compressing the flattened lower cranial nerves at the right jugular fossa. Her symptoms resolved postoperatively. Two months after the operation, she was completely free from her previous symptoms.

Clinical Report of Oriental Medicine Treatment with Bee Venom Therapy of Progressive muscle atrophy 1 Patient (봉약침(蜂藥針)을 이용(利用)한 진행성 근위축증 환자(患者) 1례(例)에 대(對)한 증례보고(症例報告))

  • Kim, Young-Ho;Yook, Tae-Han;Song, Beom-Yong;Lee, Dong-Ho
    • Journal of Pharmacopuncture
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    • v.3 no.1
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    • pp.119-140
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    • 2000
  • The authors reports in order to study the effect of Bee Venom therapy of progressive muscle atrophy. The authors investigated 1 patient who is treated at Woosuk University Oriental Medical Hospital. The patient diagnosed by MRI EMG Hematology Muscle biopsy as progressive muscle atrophy is administered by Bee Venom therapy for 4 months. Bee Venom therapy is operated by 2 times per a week(every 3 days, 0.1cc per one operation, 0.05cc per one acupuncture point). The authors checked changes of this patient's chief symptoms by comparing before and after Bee Venom therapy is operated at 30 times. After Bee Venom therapy, the patient increased motor power & ROM, decreased general cooling sense & swallowing disorder. As above, the authors conclude that better results can be obtained Oriental Medical Treatment with Bee Venom therapy in progressive muscle atrophy

Three Cases of Stroke Patients with Dysphagia with Dong-Si Acupuncture Therapy (동씨침법(董氏鍼法)을 이용한 중풍(中風) 환자의 연하장애(嚥下障碍) 치험 3례(例))

  • Lim, Woong-Kyoung;Park, Soo-Eun;Kim, Chang-Hwan;Jung, Kyung-Suk;Ock, Min-Keun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.18 no.3
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    • pp.114-120
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    • 2005
  • Objective: This study was performed to evaluate the effect of Dong-Si acupuncture therapy, on the stroke patients with dysphagia. Method: We studied three selected stroke patients with dysphagia who could follow instructions. The patients were treated with Dong-Si acupuncture (Jokch'eonkeum, Jokokeum) with Dong-Qi therapy for two weeks. We evaluated the effects by AHSA scale, VAS and MBI. Results & conclusion: Dysphagia was improved in all of three cases after treatment. But more clinical & scientific trials are expected to follow this study.

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Investigation of Infection Control Management in Occupational Therapy and Clinical Practice Students (작업치료(학)과 임상실습 학생들의 감염관리 인식 및 실태조사)

  • Won, Junghee;Chang, Moonyoung
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.3
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    • pp.95-107
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    • 2019
  • Objective : The aim of this study was to investigate the infection management awareness and infection prevention management status of students who participated in occupational therapy and clinical practice. Methods : The study was carried out from June 27th to August 4th, 2017, to survey the awareness and practice of infection control in 11 practice institutes among 193 students who had experience in 8 universities. Results : A total of 93.3 % of the respondents said that they needed education about infectious diseases, but 53.3 % of them did not receive infection prevention education at school or in clinical trial institutes. Hygienic practices for infection prevention and infection control practices related to handwashing were high, but the use of protective equipment was poor in the observation of swallowing disorder treatment. It is also important to educate students who have been trained in infection control. However, infection prevention training at universities and training centers is insufficient suggesting the importance of future infection education. Conclusion : Infection control education to prevent infection is necessary not only for clinicians but also for students participating in on-the-job training. Effective efforts are also needed in universities and clinical practice institutes so that infectious disease prevention education can be implemented. This study provides basic data for infection control education in universities and practice educational institute that perform clinical training and occupational therapy.

Prevalence and associated factors of dysphagia in patients hospitalized with acute stroke (급성 뇌졸중 입원 환자의 연하장애 유병률과 관련요인)

  • Chang, Hee-Kyung;Yun, Suk-Kyung;Gil, Cho-Rong
    • The Journal of the Convergence on Culture Technology
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    • v.5 no.1
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    • pp.417-428
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    • 2019
  • The aims of this study were to evaluate the prevalence of dysphagia in patients hospitalized with acute stroke and to identify factors associated with dysphagia. The study was conducted in a tertiary hospital and a total of 131 patients hospitalized with acute stroke (aged 34-92 years old, 58.0% male) were enrolled. The prevalence of dysphagia was 24.4% out of 131 participants and risk factors associated with dysphagia were age, neurological severity, oral health status, and dependence in activity of daily living of participants. Considering the long-term rehabilitation trajectory, it is necessary to apply the early screening and preventive nursing intervention for dysphagia during acute stage of stroke patient.

Implementation of Multi-frame Medical Image Labeling Web Application for Swallowing Disorder Analysis (삼킴장애 분석을 위한 멀티프레임 의료영상 라벨링 웹 애플리케이션 구현)

  • Dong-Wook Lim;Chung-sub Lee;Si-Hyeong Noh;Chul Park;Min Su Kim;Hee-Kyung Moon;Chang-Won Jeong
    • Proceedings of the Korea Information Processing Society Conference
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    • 2023.05a
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    • pp.8-10
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    • 2023
  • 삼킴장애는 음식물이 입에서 식도로 가지않고 걸리거나 기도(Trachea)로 흡입되는 문제를 갖는 상태이다. 특히 노인이나 신경계 질환을 앓는 환자의 경우 기도로 흡입된 음식덩이가 폐렴을 일으키고 결국에는 사망으로 이어지기에 적절한 치료와 관리가 요구된다. 보통 영상으로 판단할 수 있는 삼킴단계는 구강준비단계(Oral Preparatory Phase), 구강단계(Oral Phase), 인두단계(Pharyngeal Phase), 식도단계(Esophageal Phase) 4가지로 분류하고 삼킴장애는 침습(Penetration)과 흡인(Aspiration)으로 크게 2가지로 분류한다. 본 논문에서는 이러한 6가지 클래스를 가지는 삼킴장애 환자 비디오 파일을 라벨링하기 위한 웹 애플리케이션을 제안한다. 이를 구현하기 위해서 대용량 멀티프레임 이미지를 수신해서 분리하여 저장하도록 개발하였다. 또한 음식덩이를 정교하게 분할할 수 있도록 GrabCut 알고리즘을 적용하여 라벨링할 수 있도록 하였다. 차후 라벨러와 전문의 간의 협업이 가능하도록 라벨링 데이터의 상태를 관리할 수 있도록 개발하고자 한다.

A COMPARATIVE STUDY ON THE GENIOGLOSSUS MUSCLE AND ORBICULARIS ORIS MUSCLE ACTIVITY IN THE ANTERIOR OPEN BITE AND NORMAL OCCLUSION (전치부 개방교합자와 정상교합자의 이설근 및 구륜근 활성도에 관한 비교 연구)

  • Kang, Yong;Song, Hyung-Geun;Yoon, Young-Jooh;Kim, Kwang-Won
    • The korean journal of orthodontics
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    • v.25 no.2 s.49
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    • pp.175-185
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    • 1995
  • This study was undertaken to investigate the activities of genioglossus and orbicularis oris muscle between normal occlusion and anterior open bite group. 39 subjects without the experience of orthodontic treatment and T.M.disorder were selected for this study. 20 subjects were normal occlusion. 19 subjects were anterior open bite. The twenty items were measured from the cephalometric headplates, and EMG recording of the genioglossus, orbicularis oris muscle were taken at rest position, water swallowing, jaw opening, isometric tongue protrusion, maximum tongue protrusion. All data were analyzed and processed with the computer statistical method. The following results were obtained: 1. Except at rest position. the muscle activities of genioglossus muscle in anterior open bite were higher than in normal occlusion with singificatn difference. 2. Except druing water swallowing, the muscle activities of orbicularis oris muscle in anterior open bite were higher than in normal occlusion with significant difference. 3. During maximum tongue protrusion, the geniolossus muscle of anterior open bite subjects showed the highest muscle activity. 4. Anterior open bite showed closer interrelationship between facial morphology ad the genioglossus, orbiculars oris muscle activities than that of nomral occlusion with significatn difference.

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Reliability and Validity of Korean Version of the SWAL-QOL (한국판 SWAL-QOL의 신뢰도와 타당도)

  • Kim, Se-Yun;Cha, Yu-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.5
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    • pp.2981-2988
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    • 2014
  • The Purpose of the this study was to identify reliability and validity of the Korean version of the Swallowing Quality of Life questionnaire(KSWAL-QOL). The study was performed in 71 patients diagnosed dysphagia by videofluoroscopy and 80 healthy swallowers. The reliability was good with a Cronbach's ${\alpha}$ and intraclass correlation coefficient of .86~.96 and .80~.93, respectively. The Pearson product moment correlation coefficients between KSWAL-QOL scales ranged from .17~.74 which was showed significant correlation. Healty swallowers scored higher than dysphagic patients on all scales and statistically significant differences were observed across all the scales between healthy swallowers and dysphagic patients(p<.01). Tube feeders scored lower than non-tube feeders on all scales and statistically significant differences were observed in all the scales except sleep(p<.05). There are significant difference between diet steps in all scales except eating desire, communication, fear and people on diet fourth step feeding had the highest scores on the all scales(p<.05). Because KSWAL-QOL seems to be a reliable and valid tool, it is considered to be appropriate as a tool to measure quality of life of patient with swallowing disorder.

Nutrient and Carotenoid Intakes and Dietary Habits in Mentally Disabled Adults (성인 정신적 장애인의 영양소와 카로티노이드 섭취 수준 및 식습관에 대한 연구)

  • Ahn, Mi Yeon;Moon, Hwang woon;Chung, Hae Yun;Park, Yoo Kyoung
    • Korean Journal of Community Nutrition
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    • v.20 no.3
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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.