• 임상간호연구
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• 제22권1호
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• pp.1-9
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• 2016

Purpose: This study was done to identify effects of oral care protocol on oral mucositis and oral care performance in hematologic malignancy patients receiving chemotherapy. Methods: The design of this study was a nonequivalent control group pretest-posttest design. Both groups were patients diagnosed with hematologic malignancies who were receiving chemotherapy-each group had 20 patients. In the experimental group, patients were given intensive education on oral care based on the oral care protocol, whereas in the controlled group, each patient was given an educational brochure. Before chemotherapy, and 3 days, 7 days, and 14 days after chemotherapy, oral mucositis status of two groups were assessed using the guide to physical assessment of the oral cavity. Oral care performance was examined before chemotherapy and 14 days later. Results: The experimental group with the oral care protocol showed a significant difference (F=18.15, p<.001) in the oral mucositis status, and also in oral care performance (t=-10.33, p<.001). Conclusion: Findings indicate that the application of the oral care protocol is an effective tool for lowering the occurrence of oral mucositis and enhancing oral care performance in hematologic malignancy patients receiving chemotherapy.

• 대한간호학회지
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• 제49권2호
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• pp.149-160
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• 2019

Purpose: The purpose of this study was to examine the effects of oral cryotherapy on oral mucositis, reactive oxygen series, inflammatory cytokines, and oral comfort in patients undergoing chemotherapy for gynecologic cancers. Methods: Participants were randomly assigned to the experimental group (n=25, receiving oral cryotherapy during chemotherapy) and the control group (n=25, receiving the usual care consisting of 0.9% normal saline gargles three times before meals). Oral mucositis was assessed using the oral assessment guide, while oral comfort was assessed using the oral perception guide. Reactive oxygen series was measured as total oxidant stress, and the level of two inflammatory markers, interleukin-6 (IL-6) and tumor necrosis factor-alpha ($TNF-{\alpha}$), were examined. The data were analyzed using t-test, chi-square test, Fisher's exact test, Mann-Whitney U-test, and repeated measures analysis of variance. Results: There was a significant difference in the oral mucositis score, reactive oxygen series score, $TNF-{\alpha}$ level, and oral comfort score between the two groups, and there were significant changes over time and in the group-by-time interactions. There was a significant difference in the IL-6 score between the two groups, but there were no significant changes over time or in the group-by-time interactions. Conclusion: The study results revealed that oral cryotherapy was more effective than the usual care regime of normal saline gargles for reducing oral mucositis, reactive oxygen series, and inflammatory cytokines and for improving oral comfort in gynecologic cancer patients undergoing chemotherapy.

• 종양간호연구
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• 제10권2호
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• pp.119-128
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• 2010

Purpose: This study aimed to evaluate the effectiveness of continuous nutritional education and oral mucositis management on the nutritive status of patients who received hematopoietic stem cell transplantation (HSCT). Methods: After randomly allotting 72 patients who received HSCT to either an experimental group or a control group, intensive and continuous care for preventing malnutrition was conducted in the experimental group while usual routine care was conducted in the control group. The changes of the body scale, blood chemistry profile, oral intake calories, nausea and vomitus, and oral stomatitis scores were measured at three points during their hospitalization using a oral assessment guide and nutrition analysis program: admission, HSCT, and discharge day. The differences between the scores of two groups were analyzed by repeated measures analysis of covariance. Results: The number of total lymphocytes was significantly improved in the experimental group after transplantation (p<.001). Nausea and vomiting score was significantly decreased in the experimental group during the conditioning regimen (p<.001). Conclusion: It was found that continuous nutritional education and oral mucositis control is an effective intervention by improving immune condition. Further investigations concerning direct examination of oral intake with controlling the effect of the chemotherapy are needed to ultimately discern the impact of varying oral nutrition patterns during HSCT.

• 임상간호연구
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• 제17권1호
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• pp.113-122
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• 2011

Purpose: This study was conducted to develop and evaluate an oral care protocol for cancer patients receiving chemotherapy. Methods: The participants in this study were cancer patients in Severance hospital in Seoul. A total of 31 patients were assigned to the experimental group, and 29 patients to the control group. Data were collected from August 1 to October 5, 2010. The protocol included definition and symptom of oral mucositis, self-check method of oral status, prophylactic method of oral mucositis (oral care, eating habits, and gargling) and management of oral mucositis. Oral Assessment Guide (OAG) was used as the measurement tool of oral mucositis in this study, Oral Care Performance Scale was used as the measurement tool of oral care performance status. Data were analyzed with a $x^2-test$ and t-test, and repeated measures ANOVA, using SPSS/WIN 18.0 program. Results: Patients in the experimental group receiving the oral care protocol had a significant difference (t=-2.938, p=.005) in the oral care performance compared to the control group. However, there was no significant difference (F=1.255, p=.274) in the oral mucositis status between two groups. Conclusion: This study showed that the oral care protocol could improve oral care performance status for the patients under chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3611-3614
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• 2016

Background: Propolis based preparations have a wide range of applications in various specialties of dentistry. The aim of this clinical trial was to test the efficacy of propolis as a mouthwash in the reduction of chemotherapy induced oral mucositis (OM) in a single center. Materials and Methods: In this randomised, controlled study patients undergoing chemotherapy were included consecutively and randomised to an experimental group receiving propolis mouthwash (n = 20) and a control group receiving diluted water (n=20). Oral mucositis, erythema and eating and drink ability were assessed at baseline and after 3 and 7 days using the World Health Organization (WHO) scale and the oral mucositis assessment scale (OMAS). Results: There were significant differences in OM, wound and erythema in propolis group compared to placebo, but no significant difference in eating and drink ability. However, it was interesting that 65% of the patients in the propolis group were completely healed at day 7 of the trial. No significant adverse events were reported by the patients. Conclusions: This study found that oral care with propolis as mouthwash for patients undergoing chemotherapy is an effective intervention to improve oral health. Our findings shouldlencourage health practitioners to apply propolis mouth rinse for the oral care of patients under chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• 제15권8호
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• pp.3641-3644
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• 2014

The present study aimed to determine the effect of oral ${\beta}$-glucan on mucositis and leukopenia in 62 consecutive patients with colorectal cancer treated with an adjuvant FOLFOX-4 regimen. The patients were retrospectively evaluated in 2 groups: one group received ${\beta}$-glucan and the other did not (control group). Leucocytes, neutrophils, and platelets were evaluated before and 1 week after chemotherapy and oral mucositis and diarrhea were noted. Leucocyte and neutrophil counts after chemotherapy in the ${\beta}$-glucan group were $7,300/mm^3$ and $3,800/mm^3$, respectively, and the reductions, as compared to baseline, were not significant (p=0.673 and 0.784). The median platelet count was $264,000/mm^3$ after chemotherapy in the ${\beta}$-glucan group and the reduction, as compared to baseline, was borderline significant (p=0.048). In the control group, reduction in leucocyte, neutrophil, and platelet counts was statistically significant. Oral mucositis and diarrhea were less common in the ${\beta}$-glucan group. We conclude that ${\beta}$-glucan can be used to reduce the adverse effects of chemotherapy.

• Radiation Oncology Journal
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• 제26권4호
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• pp.257-262
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• 2008

목 적: 두경부 영역에 대한 방사선치료 시 발생하는 구강점막염은 방사선치료로 유발되는 급성 합병증 중에서 가장 심각하고 해결해야 할 문제점이다. 따라서 본 저자들은 마우스를 이용하여 방사선 구강점막염 모델을 확립하고자 본 연구를 진행하였다. 대상 및 방법: 본 실험에는 $7{\sim}8$주령의 20 g 내외의 웅성 BALB/c 마우스 55마리를 사용하였다. 1주일간 순화 후 대조군 5마리를 제외하고 체중에 따라 무작위로 3군으로 나누고 마우스의 두경부에 각각 16, 18, 20 Gy의 방사선을 조사하였다. 방사선조사 후 체중을 매일 측정하고 생존 유무를 관찰하였다. 방사선조사 후 1, 2, 3, 5, 7, 9, 14일째 마우스를 경추탈골사 한 후 설조직을 채취하고 hematoxylin & eosin (H&E) 염색으로 조직학적 변화를 확인하였다. 결 과: 방사선조사군의 경우 5일 이후 급격한 체중감소를 나타내었고 18 Gy와 20 Gy군에서 마우스가 사망하였다. 16 Gy군에서는 5일부터 9일까지는 평균 체중이 감소하였으나 이후 회복되었다. 조직학적 변화를 관찰한 결과 방사선조사 후 시간경과에 따라 상피층의 두께가 얇아지면서 편평해지는 경향을 나타내었으며 7일과 9일째에 가장 심각한 상태를 나타내었다. 대조군에서 평균 $113.50{\pm}2.41{\mu}m$이던 상피층 두께가 방사선조사 후 시간이 지남에 따라 유의하게 그 두께가 감소하였으며 7일째에는 43.9% 감소한 $63.70{\pm}3.28{\mu}m$로 최저치를 나타내었다(p<0.0001). 14일째에는 $121.00{\pm}2.82{\mu}m$로 대조군과 유의한 차이가 없어 정상적으로 회복되는 것으로 나타났다. 결 론: BALB/c 마우스에서 방사선조사 후 마우스의 체중변화를 관찰 할 수 있는 적절한 방사선 선량은 16 Gy였다. 또한 구강 내 상피조직의 현저한 손상은 방사선조사 후 7일과 9일째 관찰할 수 있었고 9일째에는 심각한 궤양화가 나타났다. 18 Gy와 20 Gy 조사 후 9일과 10일째에 모든 마우스가 사망하였지만 16 Gy 조사군에서는 14일째 조직이 정상적으로 회복되었다.

• Journal of Periodontal and Implant Science
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• 제45권2호
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• pp.56-61
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• 2015

Purpose: The aim of this study was to evaluate the effectiveness of powered toothbrushes for plaque control in patients with peri-implant mucositis, in comparison with manual toothbrushes. Methods: This randomized, prospective, controlled, clinical parallel study compared the efficacy of manual and powered toothbrushes for plaque control in implant restorations. Patients with bleeding on probing, no residual pocket depth (as indicated by a pocket probing depth ${\geq}5mm$), and no radiological peri-implant bone loss were eligible for this study. Patients were requested to complete a questionnaire describing their oral hygiene habits. The duration and frequency of tooth brushing were recorded by subjects in order to assess their compliance. Clinical parameters, including the modified plaque index (mPI), the modified sulcus bleeding index (mSBI), and clinical photographs (buccal and lingual views) were recorded at baseline and at one-month and two-month follow-up visits. Results: Statistically significant differences between patients who used manual toothbrushes and those who used powered toothbrushes were found regarding the frequency of tooth brushing per day and the duration of brushing at one-month and two-month follow-up visits, while no statistically significant differences were found relating to other oral hygiene habits. A statistically significant difference in patient compliance for tooth brushing was found at one month, while no difference was found at two months. Statistically significant decreases in the mPI and the mSBI were observed in both groups from baseline to the one- and two-month follow-ups. The overall reduction of these parameters was not significantly different between the two groups, except for mPI reduction between baseline and one month of follow-up. Conclusions: Sonic-powered toothbrushes may be a useful device for plaque control in patients with peri-implant mucositis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.169-174
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• 2002

Purpose: Irradiation in the oral cancer patients causes early and late complications such as intraoral mucositis and fibrosis, with a various expression of GM-CSF and TGF-${\beta}1$. The purpose of this study was to investigate the production of GM-CSF and TGF-${\beta}1$ by the irradiated human gingival fibroblasts cultivated with lipopolysaccharide. Materials and Methods: Irradiated (total dose, 60 Gy) human gingival fibroblasts were incubated with LPS. Culture supernatants that were collected at 24, 48, and 72 hours were assessed for GM-CSF and TGF-${\beta}1$ by enzyme-linked immunosorbent assay. Results: 1. GM-CSF production in nomal gingival fibroblasts was increased with incubation time, but decreased with incubation time in irradiated gingival fibroblasts. GM-CSF production in both normal and irradiated gingival fibroblasts induced with LPS was higher than the control. 2. TGF-${\beta}1$ production in normal gingival fibroblasts was decreased after 24 hours, but, it was increased until 48 hours in irradiated gingival fibroblasts. TGF-${\beta}1$ production in normal gingival fibroblasts exposed with LPS was higher than the control. Conversely, It was lower than the control in irradiated gingival fibroblasts exposed with LPS. Conclusion: This indicates that irradiation in gingival fibroblasts may play an important role in radiation-induced intraoral mucositis and fibrosis. However, LPS decreases the production of TGF-${\beta}1$ in the irradiated gingival fibroblasts.

• 대한간호학회지
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• 제26권2호
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• pp.428-442
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• 1996

Stomatitis is a common toxicity associated with the administration of certain cancer chemotherapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to establish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subsect were divided into three groups : control group : not gargling experimental group A : normal saline gargling (4 times a day) experimental group B : nystatine solution gargling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times(once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X/sup²test. The results are as follows : 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B.（X/sup²＝0.002 P＝0.001）. The grade of stomatitis(mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A F＝1.96 P＝0.0024）. In incidence of tongue change, control group, experimental group B were significantly higher than experimental group B（F＝6.84 P＝0.0039）. In control group and experimental group A. oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.