• 제목/요약/키워드: swallowing disorder

검색결과 70건 처리시간 0.032초

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

  • 손성일;손정희;장현중;이상한;차두원;백상흠
    • 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.

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

  • 변해원
    • 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.

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

  • 전혜인;이예찬;김정훈;박규형;차인호;박영범
    • 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.

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

  • 오세정;홍용희;이용화;이승태;기창석;이동환
    • 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.

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

  • 유재하;최병호;이천의;김종배
    • 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.

10 year follow up of a boy with Lesch Nyhan Syndrome

  • Kim, Sook Za;Song, Wung Ju
    • 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.

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

  • 김혜경;강경화;이용태
    • 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.

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

  • 김경묵;장안수;김선욱;송병철;염충호;정주영;황진수;최국명;이홍섭
    • 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.

Determining the Onset Age for Early Intervention of Oral Frailty

  • Hye-Lim Hong;Nam-Hee Kim
    • 치위생과학회지
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    • 제24권1호
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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.

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

  • 한영미;박재홍
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권2호
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    • pp.116-121
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    • 2008
  • 목 적: 윤상인두 협조불능은 원인 불명의 드문 질환으로 윤상인두의 이완과 연관된 인두의 수축 지연이 특징이다. 출생 초기에 연하곤란을 일으키는 타 질환과의 감별과 임상 경과에 대한 이해가 조기 진단과 적절한 치료를 위해 필요하나 이에 대한 연구가 많지 않다. 방 법: 2000년 1월부터 2006년 12월까지 부산대학교 병원 소아과에서 임상 소견과 비디오 식도 촬영 또는 식도 조영술에서 윤상인두 협조불능으로 진단받은 17예를 대상으로 병록지와 검사 소견을 후향적으로 분석하였다. 결 과: 남녀 비는 1:1.1 (남자 8예, 여자 9예)이었다. 평균 나이는 12.5${\pm}$17.5일로 7일 이내 10예(58.8%), 7~30일 5예(29.4%), 30일 이상 2예(11.7%)였다. 체중은 3백분위수 미만 8예(47.1%), 10백분위수 이하 11예(64.7%)였다. 미숙아 6예(35.3%), 저출생 체중아 7예(41.2%), 부당경량아 2예(11.8%)였다. 동반 질환은 심장기형 3예, 염색체 이상 2예, 후두연하증 1예였다. 주요증상은 재발성 흡인성 폐렴 10예(58.8%), 수유곤란 9예(52.9%), 수유 시 호흡곤란 4예(23.5%), 구토와 목맴 4예(23.5%), 기침 3예(17.6%)였다. 흡인 정도는 경도 흡인 12예(70.5%), 중증도 흡인 3예(17.6%), 중증 흡인 2예(11.8%)였다. 15예(88.2%)에서 비위관 식이를 하였다. 추적관찰이 가능했던 10예 중 9예에서 경구 식이가 가능하였다. 그 시기는 1개월까지 3예(30.0%), 6개월까지 3예(30.0%), 12개월까지 2예(20.0%), 24개월까지 1예(10.0%)였다. 하지만 흡인의 정도가 심할수록 비위관식이의 기간이 의미 있게 길었다(상관 계수 0.73, p<0.05). 결 론: 출생 직후 또는 영아 초기에 연하곤란과 반복되는 흡인성 폐렴이 있으면 비디오 식도 조영술을 이용하여 윤상인두 협조불능의 감별이 필요하다. 윤상인두 협조불능은 예후가 양호한 질환이지만 조기 진단과 관급식이 합병증의 예방과 질환의 관리에 중요하며, 흡인의 정도가 심할수록 비위관 영양 기간이 길어지므로 완전 호전될 때까지 철저한 추적관리가 중요하다.

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