• Title/Summary/Keyword: Salivary gland

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A Study on the Clinical Characteristics of Patients with Dry Mouth (구강건조증 환자의 임상적 특징에 관한 연구)

  • Oh, Jeong-Kyu;Kim, Youn-Joong;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.26 no.4
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    • pp.331-343
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    • 2001
  • Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

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Effect of Oriental Anti-Stress Agent(Bohyulanshintang) on the Salivary Gland of Rats under Restraint Stress (보혈안신탕(補血安神湯)이 스트레스에 의한 백서 타액선 조직 변화에 미치는 영향에 관한 연구)

  • Ryu, Ho-Kyung;Chun, Yang-Hyun;Lee, Jin-Yong;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.24 no.3
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    • pp.245-257
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    • 1999
  • 일상 생활에서 우리는 스트레스에 항상 노출되어 있으며, 스트레스는 생체의 신경계, 내분비계 및 면역계의 변화를 수반한 항상성의 파괴로 수많은 정신적, 육체적 질병을 야기시킨다. 특히 구강안면영역에서도 다양한 구강점막질환과 구강건조증 등을 발생시킨다. 스트레스를 제거하는 방법으로는 약물요법 및 상담, 명상요법, 종교요법 등 다양한 방법이 제시되고 있는데, 다소의 부작용이 나타나거나 꾸준히 시행하기가 쉽지 않으며 스트레스의 원인을 근본적으로 제거하기가 현실적으로 용이하지 않은 경우가 많아 스트레스에 대한 해결책에 대하여 많은 관심이 집중되고 있다. 이에 본인은 스트레스가 가해졌을 때 백서 악하선에서 관철되며 apoptosis에 대하여 세포보호작용을 하는 clusterin(SGP-2)을 이용하여 구속스트레스를 가하기에 앞서 오랫동안 경험적으로 사용되어 왔고 부작용이 적은 전통약물인 보혈안신탕을 투여하고 스트레스에 의한 타액선의 조직변화를 관찰하여 그 효과를 확인해 보고자하였다. Sprague-Dawley계 응성 백서(200-230g/bw) 33마리를 정상 대조군(3마리), 구속스트레스군(15마리) 및 보혈안신탕 투여 후 구속스트레스군(15마리)으로 나누고 이틀을 각각 구속장치에 구속한 후 0, 1, 3, 5, 7일에 회생시켜 악하선을 적출하였으며, 면역조직화학법 및 Northern Blot을 이용하여 clusterin의 변화를 관찰하였다. 그 결과는 다음과 같다. 1. 구속스트레스군의 악하선 조직에서 clusterin 단백질과 mRNA는 실험 즉일군에서만 미약하게 관찰되었으며 실험 3일과 5일 후에 핵붕괴 및 핵농축 등의 핵변화를 동반한 apoptosis가 관찰 되었다. 2. 보혈안신탕 투여 후 구속스트레스군의 악하선 조직에서 실험 5일군까지 clusterin 이 증가한 후 실험 7일군에서는 감소하였다. 3. 보혈안신탕 투여 후 구속스트레스군의 악하선 조직에서는 apoptosis가 관찰되지 않았다. 4. 보혈안신탕 투여 후 구속스트레스군의 악하선 조직에서 clusterin mRNA가 실험 전군에 걸쳐 미약하게 관찰되었다. 이상의 결과로 타액선 조직은 스트레스 단백질인 clusterin을 생산하여 세포를 보호함으로써 스트레스 상황에 적응하지만, 생리적 적용한계를 넘는 스트레스에 노출될 때는 apoptosis됨이 확인되었다. 그리고 보혈안신탕은 스트레스 상황에서 세포의 생리적 적응력을 높여 세포의 apoptosis를 억제하는 효과를 나타냄이 확인되었다. 따라서 본 연구결과는 구강건조증등의 스트레스성 타액선 질환의 병리기전을 규명하는데 도움이되리라 생각되며, 향후 항스트레스 효과를 가진 보혈안신탕등의 한약재를 임상에 적용함으로써 스트레스로 인한 신체의 병리적 변화를 다소나마 차단할 수 있을 것으로 사료된다.

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Effect of Pilocarpine Mouthwash on Xerostomia (구강건조증에 대한 필로카핀 구강양치액의 효과)

  • Kim, Ji-Hyun;Park, Ju-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.21-24
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    • 2011
  • Xerostomia is subjective feeling of dry mouth, a symptom that may or may not be accompanied by hyposalivation, an objective decrease in salivary flow. There are many causes induced xerostomia like drugs, salivary gland diseases, radiation therapy to the head and neck region, Sjogren syndrome, emotional stress etc. Insufficient salivary flow creates complications with oral candidiasis, dental caries, periodontitis, halitosis, dysgeusia. So finally, these complications lead to an overall decline in quality of life. Managements of xerostomia are eliminating or alterating the etiologic factors, relieving symptoms, preventing or correcting the consequences of salivary dysfunction, treating underlying disease and stimulating salivation. One of the salivation stimulation agents studied to treat xerostomia was the pilocarpine muscarinic agonist. Pilocarpine is one of salivation stimulants, a parasympathomimetic drug and non-selective muscarinic receptor agonist. Systemic pilocarpine has been used to stimulate salivary secretion. But systemic administration of pilocarpine has limitations such as increased risk of side effects and contraindications. Side effects of systemic pilocarpine administration are sweating, urinary and gastrointestinal disturbance, risk of cardiovascular and pulmonary disorders. This drug must be used carefully by patients with controlled asthma, chronic bronchitis, pulmonary or cardiac disease. Patient with acute asthma, narrow angle glaucoma, iritis should not use pilocarpine. Like this, systemic pilocarpine has many limitations. So, many investigators also have looked at the effectiveness of topical pilocarpine. Here we present patients with xerostomia which was relieved by pilocarpine mouthwash.

Predictors of Distant Metastasis in Adenoid Cystic Cancer of Salivary Gland (타액선 선양낭성암종의 원격 전이 예측인자에 관한 연구)

  • Kim, Kang Woo;Kim, Yeon Soo;Oh, Kyoung Ho;Park, Min Woo;Cho, Jae-Gu;Baek, Seung-Kuk;Woo, Jeong-Soo;Jung, Kwang-Yoon;Kwon, Soon Young
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.1-4
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    • 2014
  • 배경 및 목적 타액선 선양낭성암종은 느린 성장 속도와 늦은 원격 전이를 특징으로 하는 드문 상피성종양이다. 본 연구는 다양한 임상 병리학적 변수를 통해 선양낭성암종의 원격 전이에 영향을 주는 인자를 조사하고자 하였다. 대상 및 방법 1999년 10월부터 2011년 12월까지 본원 이비인후과에서 타액선 선양낭성암종으로 진단되어 치료 받은 44명(남자 19명, 여자 25명)을 대상으로 원격전이를 유발하는 위험 인자를 조사하였다. 8명의 환자는 배제 기준에 따라 제외하였다. 환자의 평균 연령은 54세였다. 환자의 병리 보고서, 종양의 크기, T 병기, 수술 절제연의 종양 존재 유무, 신경 조직 침습, 림프절 전이가 조사되었다. 결 과 15명의 환자가 원격전이가 있었으며 21명은 원격 전이가 없었다. 원격 전이를 유발할 수 있는 여러 인자들을 비교하였을 때, 원격 전이는 수술 절제연의 종양 세포 잔존(p=0.014), 종양의 크기(p=0.038), 진행된 T 병기(p=0.024)가 통계적으로 유의하게 연관성이 있었다. 림프절 전이와 신경 조직 침습은 원격 전이와 연관이 없었다. 결 론 종양의 크기, 진행된 T 병기, 수술 후 절제연의 종양 세포 잔존은 원격 전이의 예측 인자로 생각된다. 따라서 이에 해당하는 환자의 경우 더욱 철저한 관리 및 경과 관찰을 요한다.

Analysis of Thymosin β4 and Vascular Endothelial Cell Growth Factor (VEGF) Expression in Normal Human Tissues Using Tissue Microarray (Tissue microarray를 이용한 사이모신 베타4(Thymosin β4)와 vascular endothelial cell growth factor (VEGF)의 정상 인간 조직 발현 양상 연구)

  • Ock, Mee-Sun;Cha, Hee-Jae
    • Journal of Life Science
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    • v.19 no.12
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    • pp.1777-1786
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    • 2009
  • Thymosin ${\beta}4$, a small protein containing 43 amino acids, has multi-functional roles in cell physiology. It was first identified as a thymic maturation factor and recently has been shown to accelerate wound healing, hair growth, angiogenesis, tumor growth, and metastasis. It was also reported to play a key role in developing organs, including the nervous system and heart. Thymosin ${\beta}4$ induces the expression of vascular endothelial cell growth factor (VEGF), laminin-5, and other important biologically active genes. Using tissue microarray analysis, we investigated the expression patterns of thymosin ${\beta}4$ and VEGF in various normal human adult tissues. Thymosin ${\beta}4$ was highly expressed in the liver, pancreas, ductal epithelium of the salivary gland, and heart, and moderately expressed in the skin, lung, spleen, lymph node, thymus, ureter, and blood endothelial cells in both the lung and adrenal gland. The expression of VEGF generally co-localized with thymosin ${\beta}4$ and VEGF was highly expressed in the pancreas, ureter, mammary gland, liver, esophagus, and blood endothelial cells in both the lung and adrenal gland. These results suggest that thymosin ${\beta}4$ plays an important role in the function of various organs and since the expression pattern of thymosin ${\beta}4$ co-localized with VEGF, part of that function may be to induce or maintain angiogenesis.

Characterization of Intermediate Conductance $K^+$ Channels in Submandibular Gland Acinar Cells

  • Cho, Sung-Man;Piao, Zheng-Gen;Kim, Yoon-Bae;Kim, Joong-Soo;Park, Kyung-Pyo
    • The Korean Journal of Physiology and Pharmacology
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    • v.6 no.6
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    • pp.305-309
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    • 2002
  • There are some evidences that $K^+$ efflux evoked by muscarinic stimulation is not mainly mediated by large conductance $K^+$ (BK) channels in salivary gland. In this experiment, we therefore characterised non BK channels in rat submandibular gland acinar cells and examined the possibility of agonist effect on this channel using a patch clamp technique. Two types of $K^+$ channels were observed in these cells. BK channels were observed in 3 cells from total 6 cells and its average conductance was $152{\pm}7$ pS (n=3). The conductance of the another types of $K^+$ channel was estimated as $71{\pm}7$ pS (n=6). On the basis of the conductance of this channel, we defined this channel as intermediate conductance $K^+$ (IK) channels, which were observed from all 6 cells we studied. When we increased $Ca^{2+}$ concentration of the bath solution in inside-out mode, the IK channel activity was greatly increased, suggesting this channel is $Ca^{2+}$ sensitive. We next examined the effect of carbachol (CCh) and isoproterenol on the activity of the IK channels. $10^{-5}$ M isoproterenol significantly increased the open probability (Po) from $0.08{\pm}0.02$ to $0.21{\pm}0.03$ (n=4, P<0.05). Application of $10^{-5}$ M CCh also increased Po from $0.048{\pm}0.03$ to $0.55{\pm}0.33$ (n=5, P<0.05) at the maximum channel activity. The degree of BK channel activation induced by the same concentration of CCh was lower than that of IK channels; Po value was $0.011{\pm}0.003$ and $0.027{\pm}0.005$ in control and during CCh stimulation (n=3), respectively. The result suggests that IK channels exist in salivary acinar cells and its channel activity is regulated by muscaricinic and ${\beta}-adrenergic$ agonist. We conclude that IK channels also play a putative role in secretion as well as the BK channels in rat submandibular gland acinar cells.

Gene Expression Profiling of Human Salivary Gland Carcinogenesis with cDNA Microarray (인간 타액선 암발생에서 cDNA Microarray를 이용한 유전자발현 Profile연구)

  • Kim, Eun-Cheol;Shin, Min;Lee, Dong-Geun;Lee, Ju-Seok;Park, Myung-Hee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.23 no.4
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    • pp.306-323
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    • 2001
  • 종양발생에서 유전자 발현을 확인하고 profile 변화를 monitor하는 것은 병리학적 변화의 원인뿐 아니라 질병탐지와 진료의 새로운 목표를 확인하기 위한 새로운 기회를 제공해준다. cDNA microarray는 수천개의 유전자 발현을 동시에 연구할 수 있는 최신의 방법으로 피부, 유방, 간을 비롯한 다른 인체장기에서는 일부 이루어졌으나 array를 이용해 타액선 종양 연구에서는 전혀 이루어지지 않았다. 인간의 타액선 세포의 악성형질전환을 조절하는 분자적 상태를 연구하기 위해 본 연구는 약 2,000개의 유전자가 print된 cDNA microarray를 이용하여 인간 타액선 도관상피세포주(HSG)와 악하선에서 기원한 미분화 선암종(SGT)간에 비교연구를 하였다. Cy3와 Cy5 dye로 각각의 세포주에서 얻은 RNA와 reciprocal hybridize시키고 GenePix 4000 scanner로 스캔하고 GenePix Pro로 분석한 후 log2로 평균발현비율을 전환시켜 최소 2배이상의 발현을 보이는 유전자를 분석대상으로 하였다. 90%이상의 유전자가 비슷한 발현을 보였으며 2배이상의 발현을 보이는 경우 HSG가 SGT에 비해 72개 유전자가, SGT가 HSG에 비해 111개의 유전자 발현이 up-regulation되어 총 10%미만의 발현차이를 보였고 반복된 hybridization 으로부터 얻은 선택된 spot의 Pearson 상관계수는 -0.85이였다. HSG에서는 6번 p 염색체에서 과발현되는 유전자가 가장 많았고, SGT에서는 11번 q 염색체에서 가장 많았는데 HSG에서는 SGT에 비해 9, 13, 17, 18, 20, 21, 22염색체에서 과발현 되는 유전자 수가 많았고, SGT에서는 HSG에 비해 2, 7, 10, 15 염색체에서 유전자 발현 증가가 관찰되었다. HSG와 SGT간의 유전 발현을 기능별로 분석한 결과 몇 가지 주요 경로가 세포악성에 관련됨을 발견하였고, 타액선 도관상피세포에서 선암종을 구별하는데 기여하는 관련된 몇종의 과다 발현된 유전자를 찾았는데 전사인자, 성장인자 및 수용기, 세포골격 및 세포외기질 단백, 세포내 신호전달조절자 및 인자, 세포표면 항원등의 그룹으로 분류할 수 있었다. 따라서 이러한 microarray를 이용한 분자학적 표지자 연구가 악성 타액선 종양 발생과정에서 큰 도움을 줄 수 있을 뿐 아니라 유전자 조절에 의한 진단, 예후, 치료에서의 정확성을 개선시킬 수 있으리라 여겨진다.

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Intravenous contrast media application using cone-beam computed tomography in a rabbit model

  • Kim, Min-Sung;Kim, Bok-Yeol;Choi, Hwa-Young;Choi, Yoon-Joo;Oh, Song-Hee;Kang, Ju-Hee;Lee, Sae-Rom;Kang, Ju-Han;Kim, Gyu-Tae;Choi, Yong-Suk;Hwang, Eui-Hwan
    • Imaging Science in Dentistry
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    • v.45 no.1
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    • pp.31-39
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    • 2015
  • Purpose: This study was performed to evaluate the feasibility of visualizing soft tissue lesions and vascular structures using contrast-enhanced cone-beam computed tomography (CE-CBCT) after the intravenous administration of a contrast medium in an animal model. Materials and Methods: CBCT was performed on six rabbits after a contrast medium was administered using an injection dose of 2 mL/kg body weight and an injection rate of 1 mL/s via the ear vein or femoral vein under general anesthesia. Artificial soft tissue lesions were created through the transplantation of autologous fatty tissue into the salivary gland. Volume rendering reconstruction, maximum intensity projection, and multiplanar reconstruction images were reconstructed and evaluated in order to visualize soft tissue contrast and vascular structures. Results: The contrast enhancement of soft tissue was possible using all contrast medium injection parameters. An adequate contrast medium injection parameter for facilitating effective CE-CBCT was a 5-mL injection before exposure combined with a continuous 5-mL injection during scanning. Artificial soft tissue lesions were successfully created in the animals. The CE-CBCT images demonstrated adequate opacification of the soft tissues and vascular structures. Conclusion: Despite limited soft tissue resolution, the opacification of vascular structures was observed and artificial soft tissue lesions were visualized with sufficient contrast to the surrounding structures. The vascular structures and soft tissue lesions appeared well delineated in the CE-CBCT images, which was probably due to the superior spatial resolution of CE-CBCT compared to other techniques, such as multislice computed tomography.

Oncologic Outcome and Distant Metastasis of Head and Neck Adenoid Cystic Carcinoma (두경부 선낭암종의 예후와 원격 전이)

  • Yoon, Hee Soo;Park, Sang Gyu;Park, Hae Jin;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.23-28
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    • 2018
  • Background/Objectives: Adenoid cystic carcinoma is the second most common salivary carcinoma. It occurs commonly in the submandibular gland, sublingual gland and minor salivary gland. Local recurrence and distant metastasis are the leading cause of death. The aim of this study was to evaluate long-term oncologic outcomes of patients with head and neck adenoid cystic carcinoma focusing on distant metastasis. Materials & Methods: We retrospectively studied 39 patients who were diagnosed with and treated for adenoid cystic carcinoma of the head and neck from December 1996 to May 2018. The clinicopathologic characteristics of patients such as age, sex, primary site and TNM stage, and treatment methods, recurrence and distant metastasis after treatment, survival rate, and treatment method for recurrence were analyzed. Results: Of 39 patients, 18 were males and 21 were females, and the mean age was $5.9{\pm}14.4$ (28-89) years. The most common primary site was oral cavity (12 cases), and followed by sino-nasal cavity (11 cases), parotid gland (5 cases), and etc. For treatment, 17 patients underwent surgery alone, 16 received surgery with postoperative radiation therapy, and 3 patients received radiation therapy only. Three patients refused any further treatments. Recurrence occurred in 15 patients. The most common site of recurrence was the lung. The mean time to recurrence was 31.7 months. The 5 and 10 years' overall survival rate was 79.3% and 74%, respectively. The 2 and 5 years' overall survival rate was 69.6% and 62.6% in patients with distant metastasis. Conclusion: Distant metastasis is an important prognostic factor in adenoid cystic carcinoma, and eventually one third of patients have distant metastasis, especially in the lung. An appropriate treatment for lung metastasis is necessary because some patients with pulmonary metastasis survive for a quite long time.

The Role of Radiation Therapy in the Treatment of Adenoid Cystic Carcinoma of the Head and Neck (두경부에 생긴 선양 낭포암의 치료에 있어서 방사선치료의 역할)

  • Kim, Won-Dong;Park, Charn-Ii;Kim, Kwang-Hyun
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.35-41
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    • 1992
  • Forty eight patients with adenoid cystic carcinoma (ACC) in the head and neck treated between 1979 and 1990 were reviewed according to treatment modalities and clinical courses. The common site of origin was minor salivary gland ($69\%$), mostly hard palate and maxillary sinus. 11 patients received radiation therapy (RT) alone and 37 patients received combined surgery and radiation therapy. The follow-up period of the survivors ranged from 4 to 118 months (median 49.5 months). The 5 year local control rate was $69.3\%$, $67.3\%$ and 83.9$\%$ in RT alone, conservative operation (OP)+RT and radical OP+RT group, respectively (p>0.05). The control of local disease was best achieved with radical OP+RT. In postoperative RT, high dose ($\ge$60 Gy) and generous field size($\ge$64 cm$^2$) yielded a better local control rate. Actuarial overall survival rate was $79.0\%$, at 5 years and $19.2\%$ at 10 years. Distant metastases (DM) developed in $40\%$ of patients, mostly in the lung. Disease-free (NED) survival rate was $45.8\%$ at 5 years and significant differences did not exist according to primary sites and treatment options. Survival rate after the onset of DM was $19.5\%$ at 5 years. Occurrence of DM tends to lower survival significantly. In an effort to find the role of RT in the treatment of ACC, our data suggest that a well-planned postoperative RT employing a high dose and generous field size can produce high local control rate and remaining urgent problem of distant metastasis demands more effective chemotherapy for the purpose of improving survival of ACC patients.

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