• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.6
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• pp.341-348
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• 2021

Serum amylase is a representative enzyme secreted by the salivary gland and pancreas. This study investigates the clinical significance of serum amylase levels in Sjögren's syndrome (SS). Totally, 70 female subjects were enrolled, who were diagnosed as SS and had no accompanying afflictions that affected the serum amylase levels. Unstimulated salivary flow rate (U-SFR) and stimulated SFR (S-SFR), salivary gland scan, and disease activity markers (ESSDAI and ESSPRI), as well as blood tests including ESR, CRP, and amylase, were evaluated. Serum amylase showed significant positive correlation with the U-SFR and S-SFR, and was increased with higher ejection fraction (EF) of the parotid gland. However, there was no significant correlation with disease activity and inflammatory markers. Based on their average amylase levels, subjects were divided into two groups. The group with higher serum amylase levels showed a statistically significant increase in the S-SFR and EF of the parotid gland. Considering the results of the salivary gland scan, we conclude that serum amylase is significantly correlated with SFR and the EF of the parotid gland, thereby indicating that the salivary gland function remains intact in SS.

• Journal of Oral Medicine and Pain
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• v.43 no.4
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• pp.99-111
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• 2018

$Sj{\ddot{o}}gren^{\prime}s$ syndrome (SjS) is a common autoimmune disorder characterized by lymphocytic infiltration in the salivary and lacrimal glands, resulting in severe dry mouth or eyes. As a result, most of SjS patients suffer from oral dryness and can visit the department of oral medicine with or without diagnosis of SjS. Therefore, oral medicine specialists should know clues, which may indicate the diagnosis of SjS from the clinical and laboratory investigations. By the recent SjS criteria, SjS can be diagnosed by focus score, ocular staining, Schirmer's test, unstimulated whole saliva flow rate, and anti-SSA/Ro antibodies. The aim of this article is to review the diagnostic criteria, clinical investigation, and basic aspect related to SjS and to make oral medicine specialists play an important role in the detection of emerging SjS.

• Radiation Oncology Journal
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• v.22 no.2
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• pp.106-114
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• 2004

Purpose : This study was done to evaluate xerostomia fellowing intensity modulated radiotherapy for patients with head and neck cancer, and to analyze the correlation between the dosimetric parameters and xerostomia parameters. Materials and Methods : From February till October 2003, 13 patients with 3 months of follow-up were evaluated for xerostomia after being treated for head and neck cancer with IMRT. Their median age was 57 years(range: 43$\~$77). Xerostomia were assessed with a 4-question xerostomia questionnaire score (XQS) and a test for salivary flow rates (unstimulated and stimulated). The patients were also given a validated LENT SOMA scale (LSC) questionnaire. The evaluations were completed before radiation therapy (pre-RT) and at 1 and, 3 months after radiation therapy (RT). We evaluated xerostomia at pre-RT, 1 and, 3 months after RT. The association between the xerostomia parameters (XQS and LSC) and salivary flow rates (unstimulated and stimulated: USFR and SSFR) was assessed at 1 and 3 months after RT. Resrlts : All 13 patients showed no significant changes in XQS, LSC and Salivary Flow rates. As a result, we couldn't find out about xerostomia development. Based on the total mean parotid dose, 3,500 cGy, we divided these patients into two groups. The 8 patients (<3,500 cGy) showed no significant changes in XQS, LSC and Salivary Flow rates However, in 5 Patients ($\geq$3,500 cOGy), there was a significant increase in USFR and, SSFR at 3 months after RT, and for the XQS and, LSC at 1 and 3 months after RT. The correlation between XQS and, LSC, and USFR and, SSFR in ail patients (13) was significant at 3 months after RT. The correlation had a tendency to the decrease for USFR and, SSFR in proportion to the increase of XQS and, LSC. Conclusion : Based on the results of this study, IMRT seem to be an effective treatment to significantly decrease the xerostomia. XQS and, LSC seem to be a effective tool for predicting the xerostomia. A total parotid gland mean dose of <3,500 cGy should be a planning goal if substantial sparing of the gland function is desired. Furthermore, patients should be enrolled in a study to define a more accurate threshold dose for the parotid gland.

• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.262-274
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• 1999

Several alternatives for increasing the fluoride concentration in the mouth, such as water fluoridation, ingestion of fluoride supplements, fluoride paste, fluoride mouthrinse, application of fluoride gel are available. There is an impressive body of evidence that the topically deliverd fluorides are clinically effective in inhibiting the progression of dental caries. Recent studies on the cariostatic action of fluoride have indicated the importance of fluoride in the fluid environment of the teeth. The fluoride levels in unstimulated whole saliva can be considered indicative of F in the aqueous phase available for interaction with the tooth surface at a given time. The retention of F in the mouth after topical fluoride treatment is considered to be an important factor in the clinical efficacy of F. The aim of this study was to determine the elevation and clearance of fluoride in whole saliv after the following topical flouride treatments using HMDS-diffusion technique and fluoride ion electrode. The obtained results were as follow: 1. Average salivary fluoride concentration in the unstimulated whole saliva was $0.0152ppm{\pm}0.0091ppm$. Unstimulated salivary flow rate was between 0.34-0.36ml/min and there was no statistically significant difference among the groups(p>0.05). 2. Except for the immediate time after treatment, fluoride levels followed as APF gel>neutral gel>F-rinse>F-paste. There was no statistical difference between the salivary F concentration of F-paste group and that of control group after 2 hours. In case of F-rinse group, after 3 hours the concentration had dropped to baseline value. But there was statistically significant difference among the F concentraion of F gel groups and that of control group(p<0.05). 3. The mean $AUC_{0-120min}$ values were followed as neutral gel>APF gel>F-rinse>F-paste, and the values of the two former groups were significantly higher than those of the two latter groups(p<0.05).

• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.99-109
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• 2016

Purpose: This study investigated factors influencing the xerostomia symptoms in the patients with temporomandibular disorders (TMDs). Methods: Eighty-six participants over the age of twenty were randomly enrolled from patients with TMDs. The patients were diagnosed by Diagnostic Criteria-TMD (DC-TMD). Intensity of the pain and level of stress of the patients were recorded using TMD pain visual analogue scale (VAS) and stress VAS, respectively. The Symptom Checklist-90-Revised (SCL-90R), dry mouth symptom questionnaire, unstimulated salivary flow rate (USFR) and oral moisture were measured. Results: The patients who had above the mean of the TMD pain VAS had significantly higher scores on the stress VAS, subjective dry mouth symptoms and T-score of somatization. The patients who suffered from pain more than three months had significantly higher TMD pain VAS, subjective dry mouth symptoms and T-score of somatization. There were no significant differences in xerostomic symptoms according to the diagnosis of TMDs. Moreover, TMD pain VAS and the stress VAS did not correlated to USFR and oral moisture. Conclusions: The level of individuals' TMD pain and stress significantly affect their subjective dry mouth symptoms, however, it did not affect USFR and oral moisture.

• The Journal of Korean Medicine
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• v.32 no.4
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• pp.100-110
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• 2011

Objectives: The aim of this study was to investigate the usefulness of a comprehensive diagnosis of yin-deficiency and heart rate variability in halitosis patients. Methods: We surveyed 62 halitosis patients visiting the Halitosis Clinic in the Kyung Hee University Oriental Medicine Hospital from August 2010 to April 2011. The subjects were evaluated on self-assessed severity of halitosis and xerostomia using visual analogue scale (VAS) score and yin-deficiency condition (based on the 10-item Yin-deficiency Questionnaire). Salivary function was measured by the unstimulated salivary flow rate (USFR) and heart rate variability (HRV) parameters were recorded by SA-2000E (Medicore Co. Ltd., Korea). Results: There were substantial significant positive correlations between halitosis, xerostomia VAS scores and yin-deficiency scores. There was significant negative correlation between xerostomia VAS score and USFR. Compared to the normal USFR group (USFR>0.1$m{\ell}$/min), the decreased USFR group (USFR${\leq}0.1m{\ell}$/min) showed significant lower values of Total Power (TP), Lower Frequency (LF), and High frequency (HF). Conclusions: The results of this study suggest that the comprehensive diagnosis of yin-deficiency and HRV are useful in diagnosing of halitosis patients with xerostomia. Therefore, we assume that improvement of yin-deficiency condition can be a potentially effective way to treat halitosis with xerostomia.

• Journal of Oral Medicine and Pain
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• v.42 no.3
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• pp.72-80
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• 2017

Purpose: Pilocarpine as a salivation stimulant in pill form has mostly been used to relieve oral dryness for xerostomic patients but its use may often be limited due to variable side effects from systemic absorption. Therefore, the purpose of this study was to investigate the effects of pilocarpine mouthwash on salivation according to the variable concentration and duration for healthy volunteers. Related adverse effects and subjective assessment on its effects on salivation were also examined. Methods: This study was performed as placebo-controlled, double-blind, randomized clinical trial. Thirty healthy volunteers (male=23, mean age=22.2 years) were randomly allocated to 6 groups with the different concentration of pilocarpine mouthwash (placebo, 0.1%, 0.5%, 1.0%, 1.5%, and 2.0%). The whole experiment consisted of 3 sessions according to the duration of mouthwash, i.e., 1, 3, and 5 minutes with the mean wash-out period ${\geq}2$ days between the sessions. Unstimulated whole saliva was collected before and after gargling with a mouthwash. Results: Salivation of the higher concentration groups ${\geq}1%$ significantly increased than those of lower concentration group. The application period of mouthwash did not cause any changes of salivary flow rate at the higher concentrations ${\geq}1.0%$. The lower concentrations of 0.5% and 0.1% had no effects on salivation even after 5-minute mouthwash. There was no significant difference between blood pressure and pulse rate before and after use of mouthwash. Conclusions: From the results of the current study, pilocarpine mouthwash with at least 1.0% concentration more than a minute might be clinically effective in salivation without any serious side effects. Dose of mouthwash rather than duration seems to be a critical factor to salivation.

• The Journal of Internal Korean Medicine
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• v.39 no.4
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• pp.699-707
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• 2018

Objectives: This study was designed to investigate characteristics of digital infrared thermal imaging (DITI) and quantitative evaluations in patients with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 38 patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1st, 2018 to June 30th, 2018. The subjects were evaluated with digital infrared thermal imaging (DITI) and for heart rate variability (HRV), unstimulated salivary flow rate (USFR), and the proportion of coated tongue. Results: Most patients showed higher temperatures on the central part of the tongue (T2) than on the middle of the forehead (T1). The patients tended to have a high Low frequency/High frequency (LF/HF) ratio. Statistically significant negative correlations were noted between the age of patients and the temperature of T1 and T2. Statistically significant negative correlations were also observed between the LF/HF ratio and 'T1-T2' values. Conclusions: This study suggests that DITI and HRV are useful for the validation of patients with BMS. Correlations between the result values suggest that sympathetic function acceleration is related to temperature distribution and, ultimately, to symptoms.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.363-371
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• 2018

Objective: The aim of this study was to investigate the clinical characteristics of patients showing fissured tongue (FT) with burning mouth syndrome (BMS). Methods: We reviewed the clinical records of 16 FT patients with BMS who visited the Oral Diseases Clinic of Kyung Hee University Korean Medicine Hospital from March 1, 2017 to February 28, 2018. The subjects were graded by FT classification and compared with each group on a numeral rating scale (NRS) of tongue pain, proportion of coated tongue, unstimulated salivary flow rate (USFR), Ryodoraku, and heart rate variability (HRV) results. Results: FT grade had no significant correlation with NRS of tongue pain and USFR. FT grade had a substantially significant positive correlation with BMI and LF/HF ratio in HRV. FT grade had a substantially significant negative correlation with proportion of coated tongue. The most frequent accompanying symptoms were xerostomia and insomnia. Conclusions: The results of this study suggest that FT has no correlation with tongue pain in BMS. Rather, FT seems to correlate with sympathetic function acceleration.

• The Journal of Internal Korean Medicine
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• v.35 no.4
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• pp.532-545
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• 2014

Objectives: The purpose of this study was to evaluate the clinical effect of Korean medical treatments such as herbal medicine, acupuncture, and electroacupuncture by using the portable gas chromatograph OralChroma$^{TM}$ (Abimedical, Japan) in halitosis patients. Methods: We surveyed 30 halitosis patients who had visited the Oral Diseases Clinic in the Korean Medical Hospital of Kyunghee University from October, 2013 to November, 2014. Before starting Korean medical treatment, the subjects were evaluated on sociodemographic characteristics, severity of discomfort using visual analogue scale (VAS), unstimulated salivary flow rate (USFR), and halitosis associated life-quality test (HALT) score. To evaluate the therapeutic effect, we measured the volatile sulfur compounds (VSCs) in breath by using OralChroma$^{TM}$ before and after 3 weeks treatment. Results: The concentration of total VSCs measured by OralChroma$^{TM}$ significantly decreased (p=0.001). Furthermore, the level of hydrogen sulfide and methyl mercaptan also significantly decreased (p<0.05). However, although the level of dimethyl sulfide decreased as well, there was no significance(p>0.05). Conclusions: Korean medical treatment was effective in treating halitosis by decreasing VSCs. Further study, with well-designed randomized controlled trials with larger number of cases will be needed in the future.