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The Effects of Bolus Consistencies on the Swallowing Safety in Poststroke Patients
Allison Trent, 박태옥(Taeok Park),Elizabeth Oommen, 김영선(Youngsun Kim) 한국언어청각임상학회 2014 Communication Sciences and Disorders Vol.19 No.2
배경 및 목적: 진한 액체나 퓨레 음식은 병원이나 요양원의 삼킴장애 환자에게 가장 많이 쓰이는 보상치료방법이다. 본 연구의 목적은 흡인을 보이는 뇌졸중 환자가 다양한 음식점도(묽은 액체, 진한 액체, 퓨레)를 삼켰을때 삼킴안전에 변화를 보이는지와 다양한 음식 사이에는 삼킴안전에 차이를 보이는지 알아보는 것이다. 방법: 뇌졸중 환자 24명 중 묽은 액체에서 흡인을 보인 환자 12명의 비디오투시조영검사 자료에서 각 환자의 5 mL의 묽은 액체, 진한 액체, 퓨레의 삼킴을 분석하였다. 본 연구에서 삼킴의 안전을 측정하기 위해 사용한 침습-흡인 척도는 1에서 8점 척도이다. 자료분석을 위해 일원분산분석(one way ANOVA)을 실시하였고, 유의수준은 .05로 설정하였다. 결과: 흡인을 보이는 뇌졸중 환자의 경우 음식점도에 따라 침습-흡인 척도에서 유의미한 차이를 보였다(p<.01). 흡인을 보이는 뇌졸중 환자의 묽은 액체와 진한 액체, 묽은 액체와 퓨레에서 침습-흡인 척도의 감소가 나타났고(p<.01), 진한 액체와 퓨레 사이는 유의한 차이를 보이지 않았다(p=.55). 논의 및 결론: 본 연구를 통해서 다음의 두 가지 임상적 의의를 생각해 볼 수 있다. 첫째, 묽은 액체에 흡인을 보이는 환자라 할지라도 진한 액체나 퓨레로 대체하여 액체나 음식을 안전하게 삼킬 수 있다. 둘째, 환자에게 묽은 액체를 대체할 것을 선택 시 진한 액체와 퓨레는 삼킴안전에 차이가 없다는 것이다. Objectives: Thickened liquids or pureed foods are one of the most frequently used compensatory strategies in hospitals and long-term care facilities for patients with dysphagia. The purpose of this study was to determine whether different bolus consistencies (thin liquid, nectar thick liquid, and puree) would improve the safety of swallowing and whether there would be a difference within these consistencies on swallowing safety in poststroke patients. Methods: Videofluoroscopic swallowing examinations (VFSEs) were obtained from 24 poststroke patients. Among them, 12 poststroke patients showed aspiration in thin liquid. VFSEs of these patients were advanced to swallowing nectar thick liquid and puree. To determine the safety of swallow in changes of bolus consistency, penetration-aspiration scale (P-A scale) was used to rate the swallow on a scale of 1 to 8. Statistical comparisons were made by one-way analysis of variance (ANOVA), and the significance level was set at p<.05. Results: For poststroke patients with aspiration, change in bolus consistency had a significant effect on the P-A acale rating (p<.01). The poststroke patients with aspiration exhibited significant decreases in P-A scale between thin liquid and nectar thick liquid and between thin liquid and puree (p<.01), but not between nectar thick liquid and puree (p=.55). Conclusion: The findings have two clinical implications. First, thickened liquid or puree provided an alternative way to obtain liquid or food safely to poststroke patients who aspirated thin liquids. Second, there is no difference on swallowing safety between nectar thick liquids and puree in poststroke patients with aspiration.
The Effects of Bolus Consistencies on the Swallowing Safety in Poststroke Patients
Allison Trent,박태옥,Elizbeth Oommen,김영선 한국언어청각임상학회 2014 Communication Sciences and Disorders Vol.19 No.2
Objectives: Thickened liquids or pureed foods are one of the most frequently used compensatory strategies in hospitals and long-term care facilities for patients with dysphagia. The purpose of this study was to determine whether different bolus consistencies (thin liquid, nectar thick liquid, and puree) would improve the safety of swallowing and whether there would be a difference within these consistencies on swallowing safety in poststroke patients. Methods: Videofluoroscopic swallowing examinations (VFSEs) were obtained from 24 poststroke patients. Among them, 12 poststroke patients showed aspiration in thin liquid. VFSEs of these patients were advanced to swallowing nectar thick liquid and puree. To determine the safety of swallow in changes of bolus consistency, penetration-aspiration scale (P-A scale) was used to rate the swallow on a scale of 1 to 8. Statistical comparisons were made by one-way analysis of variance (ANOVA), and the significance level was set at p<.05. Results: For poststroke patients with aspiration, change in bolus consistency had a significant effect on the P-A acale rating (p<.01). The poststroke patients with aspiration exhibited significant decreases in P-A scale between thin liquid and nectar thick liquid and between thin liquid and puree (p<.01), but not between nectar thick liquid and puree (p=.55). Conclusion: The findings have two clinical implications. First, thickened liquid or puree provided an alternative way to obtain liquid or food safely to poststroke patients who aspirated thin liquids. Second, there is no difference on swallowing safety between nectar thick liquids and puree in poststroke patients with aspiration.
Joint Strength in High Speed Friction Stir Spot Welded DP 980 Steel
Nathan Saunders,Michael Miles,Trent Hartman,Yuri Hovanski,Sung-Tae Hong,Russell Steel 한국정밀공학회 2014 International Journal of Precision Engineering and Vol. No.
High speed friction stir spot welding was applied to 1.2 mm thick DP 980 steel sheets under different welding conditions, using PCBNtools. The range of vertical feed rates used during welding was 2.5~102 mm per minute, while the range of spindle speeds was 2500~6000 rpm. Extended testing was carried out for five different sets of welding conditions, until tool failure. These welding conditionsresulted in vertical welding loads of 3.6~8.2 kN and lap shear tension failure loads of 8.9~11.1 kN. PCBN tools were shown, in thebest case, to provide lap shear tension failure loads at or above 9 kN for 900 spot welds, after which tool failure caused a rapid dropin joint strength. Joint strength was shown to be strongly correlated to bond area, which was measured from weld cross sections. Failure modes of the tested joints were a function of bond area and softening that occurred in the heat-affected zone.
Gattis, Samuel G.,Chung, Hak Suk,Trent, M. Stephen,Raetz, Christian R. H. American Society for Biochemistry and Molecular Bi 2013 The Journal of biological chemistry Vol.288 No.13
<P>Lipopolysaccharide (LPS; endotoxin) is an essential component of the outer monolayer of nearly all Gram-negative bacteria. LPS is composed of a hydrophobic anchor, known as lipid A, an inner core oligosaccharide, and a repeating O-antigen polysaccharide. In nearly all species, the first sugar bridging the hydrophobic lipid A and the polysaccharide domain is 3-deoxy-<SMALL>d</SMALL>-manno-octulosonic acid (Kdo), and thus it is critically important for LPS biosynthesis. Modifications to lipid A have been shown to be important for resistance to antimicrobial peptides as well as modulating recognition by the mammalian innate immune system. Therefore, lipid A derivatives have been used for development of vaccine strains and vaccine adjuvants. One derivative that has yet to be studied is 8-amino-3,8-dideoxy-<SMALL>d</SMALL>-manno-octulosonic acid (Kdo8N), which is found exclusively in marine bacteria of the genus <I>Shewanella</I>. Using bioinformatics, a candidate gene cluster for Kdo8N biosynthesis was identified in <I>Shewanella oneidensis</I>. Expression of these genes recombinantly in <I>Escherichia coli</I> resulted in lipid A containing Kdo8N, and <I>in vitro</I> assays confirmed their proposed enzymatic function. Both the <I>in vivo</I> and <I>in vitro</I> data were consistent with direct conversion of Kdo to Kdo8N prior to its incorporation into the Kdo8N-lipid A domain of LPS by a metal-dependent oxidase followed by a glutamate-dependent aminotransferase. To our knowledge, this oxidase is the first enzyme shown to oxidize an alcohol using a metal and molecular oxygen, not NAD(P)<SUP>+</SUP>. Creation of an <I>S. oneidensis</I> in-frame deletion strain showed increased sensitivity to the cationic antimicrobial peptide polymyxin as well as bile salts, suggesting a role in outer membrane integrity.</P>
Cow’s Milk-Related Symptom Score in Presumed Healthy Polish Infants Aged 0-6 Months
Karolina Bigorajska,Zuzanna Filipiak,Paulina Winiarska,Anita Adamiec,Bogumiła Trent,Yvan Vandenplas,Marek Ruszczyński,Hania Szajewska 대한소아소화기영양학회 2020 Pediatric gastroenterology, hepatology & nutrition Vol.23 No.2
Purpose: The Cow's Milk-related Symptom Score (CoMiSS™), which considers crying, regurgitation, stools, skin and respiratory symptoms, was developed as an awareness tool for evaluating cow's milk-related symptoms. The scoring ranges from 0 to 33. A score ≥12 was proposed as being likely cow's milk-related and suggestive of allergy to cow's milk. This study aimed to determine the age-related CoMiSS™ values in presumed healthy infants in Poland. Methods: This was a cross-sectional study conducted in well-child clinics in two locations. Parents of the presumed healthy infants aged ≤6 months were approached during a routine checkup/vaccination visit. The exclusion criteria were as follows: presence of acute or chronic diseases, preterm delivery, treatment with therapeutic formula, and use of any food supplements (except vitamins) or medications. Results: Data from 226 infants were obtained (median age [Q1–Q3], 4 months [3–4]). The overall median (Q1–Q3) and mean (standard deviation) CoMiSS™ values were 4 (2–7) and 4.7 (3.5), respectively. The 95th percentile was 11. Scores on some, albeit not all, components of the CoMiSS™ significantly differed between age groups (crying, stools) or feeding type groups (stools and skin symptoms). Eleven children (4.9%) scored ≥12. Conclusion: This study adds to earlier age-related CoMiSS™ data by providing CoMiSS™ values in presumed healthy infants in Poland.