• Title/Summary/Keyword: swallowing disorder

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ELECTROMYOGRAPHIC ANALYSIS OF THE MASSETER AND ANTERIOR TEMPORALIS MUSCLE AFTER ORTHOGNATHIC SURGERY OF PATIENTS WITH FACIAL ASYMMETRY (안모비대칭을 동반한 하악전돌증 환자에서 악교정 수술 전후 교근과 전측두근의 근전도 변화)

  • Son, Seong-Il;Son, Jung-Hee;Jang, Hyun-Jung;Lee, Sang-Han;Cha, Du-Won;Baek, Sang-Heum
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.27 no.3
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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.

Voice Change Associated with Swallowing Disorder Caused by a Stroke After Neuromuscular Electrical Stimulation (뇌졸중으로 인한 삼킴장애 환자의 경부근육전기자극치료에 따른 음성 변화)

  • Byeon, Hae-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1665-1671
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    • 2012
  • The purpose of this study was to look into changes in voice using acoustic analysis during the process of neuromuscular electrical stimulation targeting dysphagia treatment. Fifteen man with dysphagia caused by stroke was treated neuromuscular electrical stimulation for two months and intensity of voice, $F_0$, Jitter, Shimmer, NNE were measured. The results of this study that improvement in functions of dysphagia and Jitter, Shimmer were stabilized. But there was not significantly changes of $F_0$. NNE was improved after the intervention, but still showed abnormal levels. This result suggests a possibility of effects that Neuromuscular electrical stimulation has on stabilization of Jitter, Shimmer and intensity of voice.

Fabrication of palatal lift prosthesis for a patient with palatal defect (구개결손이 있는 환자에서 연구개거상장치를 제작한 증례)

  • Jeon, Hae In;Lee, Ye Chan;Kim, Jung Hoon;Park, Kyu Hyung;Cha, In-Ho;Park, Young-Bum
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.161-165
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    • 2018
  • This report is a case of 38-year old female patient who had a chief complaint about having pronounciation disorder after going under mass excision due to mucoepidermoid carcinoma. She was referred to department of prosthodontics, Yonsei university. Palatal lift prosthesis was fabricated which was then relined with tissue conditioner. Evaluations on phonetics and swallowing were done and improvements were shown. Tissue conditioner was replaced with heat polymerizing resin and the patient was satisfied with the results of treatment.

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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THE HEALING OF MANDIBULAR FRACTURE WITHOUT INTERMAXILLARY FIXATION IN A LONG-TERM DISABLED BED PATIENT: REPORT OF A CASE (장기간 침대요양 장애환자에서 악간고정술 없이 치유된 하악 골절: 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Lee, Chun-Ui;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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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.

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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Treatment of morbid leukorrhea with Hyungsang Medicine (대하증(帶下症)의 형상의학적 치료)

  • Kim, Hye-Kyung;Kang, Kyung-Hwa;Lee, Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.2
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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.

A Case of Acute Mediastinitis Associated with Fish Bone with Successful Conservative Treatment (보존적 치료로 호전된 자리돔 가시에 의한 급성 종격동염 1예)

  • Kim, Kyung-Mook;Jang, An-Soo;Kim, Sun-Wook;Song, Byung-Cheol;Yeum, Chung-Ho;Jung, Joo-Young;Hwang, Jin-Su;Choi, Guk-Myung;Lee, Hong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.344-348
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    • 2002
  • Acute mediastinitis is a life threatening disorder that causes severe morbidity in affected patient. We experienced a case of acute mediastinitis in a 56 year-old man as a result of swallowing a fish bone (order Perciformes, Family Pomacentridae). Conservative treatment, including starvation therapy and the injection of antibiotic drugs, were successful in treating this patient. Although the optimal treatment for acute mediastinitis remains controversial, it is important to choose the appropriate strategies when encountering cases of acute mediastinitis.

Determining the Onset Age for Early Intervention of Oral Frailty

  • Hye-Lim Hong;Nam-Hee Kim
    • Journal of dental hygiene science
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    • v.24 no.1
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    • pp.1-8
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    • 2024
  • Background: Oral frailty is defined as the functional decline of the oral function due to aging, and it is associated with frailty and chronic disease. Most of the frailty intervention is for adults aged 65 years and older. However, early intervention for preventive disorder is most important. The objective of this study was to identify the age at which oral frailty surpass the "normal" range. Methods: This cross-sectional study included 719 adults (aged 30~89 years) residing in Gangwon province in May 2023. Risk of oral frailty was assessed using criteria from The Korean Academy of Geriatric Dentistry including oral function such as swallowing and mastication, and frailty. Frailty was assessed using the Kihon Checklist. To determine when oral frailty surpass the "normal" status, statistical analysis including chi-squared tests and multiple logistic regression analysis were performed using R (ver. 4.3.1). Results: There were 388 (54.0%) individuals who had a "normal" status risk of oral frailty. The risk of oral frailty was higher in the 50~54 age group compared to the 30~34 age group (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28~0.91), after adjusting for gender, education, income, occupation, and frailty (OR 0.46, 95% CI 0.22~0.94). This means that from 50~54 years old, regardless of gender, education, income, occupation, or frailty condition, there is a distinction from the "normal" status. Conclusion: We found that intervention for oral frailty is needed starting from age 50 years. This is the stage where early indications of oral frailty become apparent. Early intervention for oral frailty can lead to a decrease in the prevalence of diseases and medical expenditure. Therefore, early intervention in middle-aged adults of oral frailty is necessary to improve the quality of life related to oral health.

Clinical Features of Cricopharyngeal Incoordination in Newborns and Infants (신생아 및 영아기 윤상인두 협조불능의 임상적 고찰)

  • Han, Young-Mi;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.116-121
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    • 2008
  • Purpose: Cricopharyngeal incoordination is a rare cause of swallowing difficulties in newborns and infants; it is characterized by delayed pharyngeal contractions related to cricopharyngeal relaxation. Dysphagia and repeated aspiration are common findings despite normal sucking. We conducted this study to assess the clinical features of cricopharyngeal incoordination in newborns and infants. Methods: An analysis of the clinical data from 17 patients with cricopharyngeal incoordination who were admitted to the Department of Pediatrics, Pusan National University Hospital, between 2000 and 2006 was conducted retrospectively. The diagnosis of cricopharyngeal incoordination was established by the clinical characteristics and the videofluoroscopic swallowing studies. Results: The male to female ratio was 1:1.1 (males 8, females 9) the age range 1 to 60 days. The body weight of 11 patients (64.7%) was less than the $10^{th}$ percentile at diagnosis. Six patients (35.3%) were born prematurely. The associated anomalies or diseases were chromosomal anomaly (2 cases), congenital heart disease (3 cases), and laryngomalacia, hypoxic brain damage or neonatal seizures (1 case each). The chief complaints of patients were recurrent aspiration pneumonia (10 cases), feeding difficulty (9 cases), dyspnea (4 cases), and chocking (4 cases). The severity of aspiration on the videoesophagogram or esophagogram was mild in 12 cases. The correlation between the severity of aspiration and the duration of tube feeding after the diagnosis was significant (p<0.05). Conclusion: Cricopharyngeal incoordination should be considered in the differential diagnosis of newborns and infants, without known risk factors associated with swallowing dysfunction, when they present with unexplained respiratory problems. Although the prognosis of cricopharyngeal incoordination is good, early diagnosis and tube feeding are recommended to prevent the complications associated with this disorder.

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