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서울․경기 지역 의료기관 영양사의 연하곤란 입원환자 영양관리 업무에 대한 중요도와 수행도 인식
이경은,김다솜 동아시아식생활학회 2019 동아시아식생활학회지 Vol.29 No.5
This study examined the importance and performance of nutrition management for in-patients with dysphagia, as perceived by dietitians and investigated the perceived barriers in performing nutrition management at clinical settings. A mail survey was conducted with 554 dietitians in hospitals located in Seoul and Gyeonggi-do. The responses from 147 dietitians was finally used for data analysis. The average scores for performance and importance of nutrition management for patients with dysphagia were 2.99 points and 4.23 points respectively, based on a 5-point scale. In terms of performance, ‘inspecting and adjusting meal settings and menus for patients (3.55 points)’ was rated the highest and ‘providing nutrition education for patients and caregivers (2.65 points)’ was rated the lowest. Perceived importance was rated the highest for ‘performing nutrition counseling for patients and caregivers (4.45 points).’ According to the nutrition care process (NCP) stage, the perceived performance scores of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation were 3.06, 2.84, 3.05, and 2.88 points, respectively. The importance of the four stages of NCP was rated over 4.0 points. The performance levels of nutrition management for patients with dysphagia differed significantly by dietitians’ prior educational experience on dysphagia (p<0.001), educational background (p<0.001), and the types of hospitals (p<0.01). However, the perceived importance did not significantly differ by the general characteristics of dietitians. An importanceperformance analysis revealed that dietitians need to focus on improving performance for nutrition screening, collecting and evaluating food and nutrition related data, conducting nutrition diagnosis, performing nutrition counseling, and providing nutrition education for patients and their caregivers. The lack of time and opportunities for nutrition education and counseling, difficulty for controlling the foods brought to hospitals from home, and the lack of time for collecting data and information on patients were identified as barriers for nutrition management. Considering an increased prevalence of dysphagia, standardized diet and nutrition management guidelines for dealing with dysphagia and proper staffing of dietitians are needed to improve nutrition management for patients with dysphagia at clinical settings. Dietitians also should participate in continued education programs to develop their expertise.
홍순에 발생한 출혈성 궤양 병소의 증례보고 및 감별진단
이경은,정원,조남표,서봉직,Lee, Kyung-Eun,Jung, Won,Cho, Nam-Phy,Suh, Bong-Jik 대한안면통증구강내과학회 2011 Journal of Oral Medicine and Pain Vol.36 No.2
The vermilion zone of the lips is mucocutaneous junction between the skin and the oral mucosa of lips. Diseases of the vermilion zone may be related to a local or systemic condition, and can be manifestation of a systemic disease. In this cases, we introduced patients with hemorrhagic, ulcerative lesions on the vermilion zone and reported plasma cell cheilitis and lesion of the vermilion zone related to Stevens-Johnson syndrome(SJS).
Osteomyelitis of Mandibular Condyle : A Case Report in 9-year-old Child
이경은,최순정,서봉직,Lee, Kyung-Eun,Choi, Soon-Jeong,Suh, Bong-Jik Korean Academy of Orofacial Pain and Oral Medicine 2009 Journal of Oral Medicine and Pain Vol.34 No.3
Osteomyelitis means inflammation of the bone marrow. It usually begins in the medullary cavity, involving the cancellous bone; then it extends and spreads to the cortical bone and eventually to the periosteum. The cause is usually thought to be microbiological. But there still are factors that predispose to produce a possible bone infection such as injuries, syphilis, actionomycosis, chronic kidney failure, alcoholism, malnutrition, radiotherapy, and chemotherapy. Treatment of modalities have been directed toward eradicating microbes and improving circulation in the early stage. In the case presented, surgical debridement and IV antibiotics were the treatment of choice. Osteomyelitis in children is mainly affected in the mandible. And in childhood, the mandibular condyle is regarded as an important center of mandibular growth. Therefore, in young patients, osteomyelitis involving this region may cause a restraint of mandibular development, resulting in facial asymmetry. So diagnosis in the early stage is important in child with osteomyelitis. Recently, we have encountered an interesting case of osteomyelitis of the mandibular condyle in 9-year-old boy. So we present the case and review the literature about osteomyelitis.
하악과두 흡수(Condylar Resorption)에 대한 고찰
이경은,Lee, Kyung-Eun 대한안면통증구강내과학회 2007 Journal of Oral Medicine and Pain Vol.32 No.1
Condylar resroption, or condylysis can be defined as progressive alteration of condylar shape and decrease in mass. Although the cause is unknown, condylar resorption has been assocated with rheumatoid arthritis, systemic sclerosis, systemic erythematous, steroid usage, orthodontic treatment and orthognathic surgery. In most case, however, there is no identifiable precipitating event. Hence the term is idiopathic condylar resorption. With condylar resorption, the bone loss is resulting in a loss of posterior support in the involved condyle and the mandible can then shift. As a result, the most patients exhibit occlusal change, openbite, retrognathism, and a decrease in posterior face height. This article reports cases of condylar resorption. And the author will review factors capable of changes of condyle, pathogensis and management of conylar resorption.