• The Journal of Korean Medicine
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• v.31 no.1
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• pp.23-29
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• 2010

Objective: The aim of this prospective, case-controlled study was to assess the difference of the amount of tongue coating between halitosis and non-halitosis patients using a digital tongue diagnosis system (DTDS). Methods: Sixty-five patients complaining of oral malodor were recruited for the study. The level of volatile sulfur compounds (VSC) in the oral cavity of the patients was measured by a portable gas chromatography. All patients were then divided into two groups, the halitosis group ($H_2S{\geq}1.5ng$/10ml, or $CH_3SH{\geq}0.5ng$/10ml) and the non-halitosis group ($H_2S$<1.5ng/10ml and $CH_3SH$<0.5ng/10ml), according to the VSC level criteria published by Tonzetich. Tongue images of the two groups were acquired and analyzed by DTDS, followed by the analysis of the tongue coating scores. Results: The tongue coating scores of the halitosis group were significantly higher than of the non-halitosis group (P=0.033). Furthermore, the difference of the posterior tongue coating between the two groups was more significant (P=0.000). Conclusions: Halitosis patients were shown to have a thicker tongue coating than those in the non-halitosis group. Moreover, the posterior dorsum of the tongue should be observed more cautiously when dealing with halitosis patients. Also, the progress and state of the patient's symptom of halitosis as diagnosed objectively by the portable gas chromatography could also possibly be analyzed instead by the DTDS tongue coating score.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.15 no.1
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• pp.47-54
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• 2011

In traditional Korean medicine, inspection of the tongue is an important method of making medical diagnoses and determining prognosis. We surveyed the fluorescence characteristics of the tongue coat in the ultraviolet light. The tongue coat comprises micro-organisms, blood metabolites, leukocytes from periodontal pockets, large amounts of desquamated epithelial cells released from the oral mucosa and different nutrients. In the ultraviolet light tissues of the oral cavity generally emit weak red or green fluorescence, which is not easily seen by the human eye, but is readily detected. This fluorescence has been proved to be due to the production of porphyrins by oral micro-organisms. While the composition of motile micro-organisms on the dorsum of the tongue is not constant, variations also occur persistingly in the fluorescence characteristics of the tongue coat. But because live bacteria contain a variety of intracellular biomolecules that have specific excitation and emission wavelength spectra characterizing their intrinsic fluorescence, the tongue coat emits fluorescence. the tongue itself, on the other hand, emits very weak or not fluorescence. In conclusion, we suggests that the uncoated tongue area be eliminated from the coated tongue area with the difference between the fluorescence characteristics of the tongue and that of the tongue coat.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.19 no.2
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• pp.428-434
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• 2015

A new tongue examination model by using color analysis according to the taste division of tongue. The proposed system consists of a tongue image acquisition in a predefined template, taste region segmentation, color distribution analysis and abnormality decision of tongue by color analysis using Hue-Saturation histograms and the part of a mobile application service. We divided 4 basic taste(bitter, sweet, salty and sour) regions and performed color distribution analysis targeting each region under HSI(Hue Saturation Intensity) color model. To minimize the influence of illumination, the histograms of H and S components only except U are utilized. Using the analyzed results, the abnormality is discriminated by the criteria of the histogram range of normal tongues. Finally, a self tongue diagnosis system which can be used anytime and anywhere on mobile environment.

• Korean Journal of Oriental Medicine
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• v.13 no.3
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• pp.119-124
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• 2007

Introduction: In Oriental medicine, the status of tongue is the important indicator to diagnose one's health, because it represents physiological and clinicopathological changes of inner parts of the body. The method of tongue diagnosis is not only convenient but also non-invasive, so tongue diagnosis is most widely used in Oriental medicine. By the way, since tongue diagnosis is affected by examination circumstances a lot, its performance depends on a light source, degrees of an angle, a medical doctor's condition etc. Therefore, it is not easy to make an objective and standardized tongue diagnosis. In order to solve this problem, in this study, we tried to design a discriminant function for thick and thin coating with color vectors of preprocessed image. Method: 52 subjects, who were diagnosed as white-coated tongue, were involved. Among them, 45 subjects diagnosed as thin coating and 7 subjects diagnosed as thick coating by oriental medical doctors, and then their tongue images were obtained from a digital tongue diagnosis system. Using those acquired tongue images, we implemented two steps: Preprocessing and image analyzing. The preprocessing part of this method includes histogram equalization and histogram stretching at each color component, especially, intensity and saturation. It makes the difference between tongue substance and tongue coating was more visible, so that we can separate tongue coating easily. Next part, we analyzed the characteristic of color values and found the threshold to divide tongue area into coating area. Then, from tongue coating image, it is possible to extract the variables that were important to classify thick and thin coating. Result : By statistical analysis, two significant vectors, associated with G, were found, which were able to describe the difference between thick and thin coating very well. Using these two variables, we designed the discriminant function for coating classification and examined its performance. As a result, the overall accuracy of thick and thin coating classification was 92.3%. Discussion : From the result, we can expect that the discriminant function is applicable to other coatings in a similar way. Also, it can be used to make an objective and standardized diagnosis.

• Korean Journal of Oriental Medicine
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• v.13 no.2 s.20
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• pp.47-52
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• 2007

In Oriental medicine, the status of tongue is the important indicator to diagnose one's health, because it represents physiological and clinicopathological changes of inner parts of the body. The method of tongue diagnosis is not only convenient but also non-invasive, therefore, tongue diagnosis is one of the most widely used in Oriental medicine. But tongue diagnosis is affected by examination circumstances a lot. It depends on a light source, degrees of an angle, doctor's condition and so on. So it is not easy to make an objective and standardized tongue diagnosis. As part of way to solve this problem, in this study, we tried to design a discriminant function for white and yellow coating with multi-dimensional color vectors. There were 62 subjects involved in this study, among them 48 subjects diagnosed as white-coated tongue and 14 subjects diagnosed as yellow-coated tongue by oriental doctors. And their tongue images were acquired by a well-made Digital Tongue Diagnosis System. From those acquired tongue images, each coating section were extracted by oriental doctors, and then mean values of multi -dimensional color vectors in each coating section were calculated. By statistical analysis, two significant vectors, R in RGB space and H in HSV space, were found that they were able to describe the difference between white coating section and yellow coating section very well. Using these two values, we designed the discriminant function for coating classification and examined how good it works. As a result, the overall accuracy of coating classification was 98.4%. We can expect that the discriminant function for other coatings can be obtained in a similar way. Furthermore, if an automated segmentation algorithm of tongue coating is combined with these discriminant functions, an automated tongue coating diagnosis can be accomplished.

• Advances in Traditional Medicine
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• v.6 no.2
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• pp.112-120
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• 2006

The purpose of this study was to analyze whether quantitative evaluation of the color of the tongue substance using $L^*a^*b^*$ color coordinates system could minimize the problems arising from the different illuminating conditions or not. In controlled 4 different illuminating conditions (by natural light, flashlight, f-number, shutter speed),12 healthy subjects were photographed of their tongue substance through a digital camera (C-2100uz, Olympus Co.), both on the top surface and on the bottom surface of the tongue substance by two examiners, twice at 3 day intervals. Clinician evaluation was also performed grading the redness of the tongue substance in the form of 5-points scale by 6 clinicians. As a result, there was no significant difference in color differences between the color of the tongue substance and the reference red card in the 4 different illuminating conditions. Intra-rater reliability was satisfied and even though limitedly, inter-rater reliability was satisfied. Color differences were significantly correlated with the results by the clinicians, although they were applicable limitedly to specific illuminating conditions. Our results indicate that the application of the color differences in tongue diagnosis could not only evaluate the color information quantitatively, but also minimize the problems arising from the different illuminating conditions and that there was the significant difference in the visual evaluation of the red color of the tongue substance, both between the clinicians and between the illuminating conditions.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.16 no.1
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• pp.9-18
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• 2012

Objectives The aim of this study is to propose an optimized tongue colour interpolation method to achieve accurate tongue image rendering. Methods We selected 60 colour chips in the chips of DIC color guide selector, and then divided randomly the colour chips into two groups. The colour chips of a group (Gr I) were used for finding the optimized colour correction factor of error and those of the other group (Gr II) were used for verifying the correction factor. We measured colour value of the Gr I colour chips with spectrophotometer, and took the colour chips image with a digital tongue image system (DTIS). We adjusted colour correction factor of error to equal the chip colour from each method. Through that process, we obtained the optimized colour correction factor. To verify the correction factor, we measured colour value of the Gr II colour chips with a spectrophotometer, and took the colour chips image with the DTIS in the two types of colour interpolation mode (auto white balance mode and optimized colour correction factor mode). And then we calculated the CIE-$L^*ab$ colour difference (${\Delta}E$) between colour values measured with the spectrophotometer and those from images taken with the DTIS. Results In auto white balance mode, The mean ${\Delta}E$ between colour values measured with the spectrophotometer and those from images taken with the DTIS was 13.95. On the other hand, in optimized colour correction factor mode, The mean ${\Delta}E$ was 9.55. The correction rate was over 30%. Conclusions In case of interpolating colour of images taken with the DTIS, we suggest that procedure to search the optimized colour correction factor of error should be done first.

• The Journal of Korean Medicine
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• v.32 no.2
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• pp.42-62
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• 2011

Objective: This study was designed to identify and explore the pathological patterns of functional dyspepsia (FD) patients. We also evaluated the usefulness of the Pattern Identification Questionnaire by comparing it with other assessment tools for FD. Methods: We recruited 97 FD patients based on the Rome III criteria for FD diagnosis. The pathological patterns of the subjects were determined by the Pattern Identification Questionnaire. Their dyspepsia-related symptoms were assessed using the Gastrointestinal Symptom Questionnaire (GIS) and the Pyeongwi-san (Pingwei-san) Patternization Questionnaire. Depressive symptoms were evaluated with the Beck Depression Inventory (BDI) and quality of life with the Functional Dyspepsia-Related Quality of Life (FD-QoL) Questionnaire. Tongue coating was measured by the Digital Tongue Diagnosis System (DTDS). Results: The male to female ratio was 1:1.1, and the forties and fifties age groups were largest in number. The spleen deficiency and phlegm-dampness pattern was the most common pattern found among the FD patients. No significant differences in the GIS, BDI, FD-QoL, and DTDS scores were found among the five pattern types. All pattern types showed significant correlation with GIS, Pyeongwi-san Patternization Questionnaire, and FD-QoL scores. Conclusions: Pattern Identification Questionnaire can not only identify the pathological pattern types of FD patients but also evaluate the severity of their symptoms. Compared to conventional assessment tools for FD, it could enable a more dynamic evaluation of FD patients reflecting the severity of dyspeptic symptoms and the quality of life. Further studies on the Pattern Identification of FD patients are anticipated in order to improve the diagnosis and therapy for Korean FD patients.

• Journal of Sensor Science and Technology
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• v.28 no.5
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• pp.299-304
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• 2019

Recently, the development of rehabilitation medical technology has resulted in an increased interest in speech therapy equipment. In particular, research on articulation therapy for communication disorders is being actively conducted. Existing methods for the diagnosis and treatment of speech disorders have many limitations, such as traditional tactile perception tests and methods based on empirical judgment of speech therapists. Moreover, the position and tension of the tongue are key factors of speech disorders with regards to articulation. This is a very important factor in the distinction of Korean characters such as lax, fortis, and aspirated consonants. In this study, we proposed a Korean electropalatography (EPG) system to easily measure and monitor the position and tension of the tongue in articulation treatment and diagnosis. In the proposed EPG system, a sensor was fabricated using an AgCl electrode and biocompatible silicon. Furthermore, the measured signal was analyzed by implementing the bio-signal processing module and monitoring program. In particular, the bio-signal was measured by inserting it into the palatal from an experimental control group. As a result, it was confirmed that it could be applied to clinical treatment in speech therapy.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.17 no.3
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• pp.189-202
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• 2013

Objectives The aim of this study is to analyze the characteristics of the tongue coating pattern in the elderly patients with xerostomia. Methods Ninety-six elderly patients with xerostomia were recruited by advertisement and they visited the oral diseases clinics at Kyung Hee University Korean Medicine Hospital and Kyung Hee University Hospital at Gangdong from November, 2011 to August, 2013. After signifying the assent, the subjects who passed screening were enrolled this study. The subjects were evaluated on their clinical characteristics of xerostomia using visual analogue scale for xerostomia, dry mouth questionnaire, unstimulated salivary flow rate. In addition, Yin-deficiency questionnaire was used to evaluate the Yin-deficiency state and Winkel tongue coating index and Digital Tongue imagin system were used to measure the tongue coating of patients. Results The proportion of women was higher than that of men, and there were few smokers in this study population. This population had chronic and relatively severe xerostomia symptoms. Also, thin coating pattern was showed in this elderly patients with xerostomia and this result was regarded to the influence of Yin-deficiency. The thin coating patten was observed in the group with higher Yin-deficiency score. There was no difference in tongue coating between the hyposalivation and normosalivation group. Conclusion In the elderly patients with xerostomia, Yin-deficiency is might be considered as one of the main cause of xerostomia. Hence, it is thought that this patients showed the thin coating pattern. This results could be used in diagnosis and treatment for the elderly patients with xerostomia in traditional Korean medicine.