• Journal of the korean academy of Pediatric Dentistry
• /
• v.36 no.4
• /
• pp.586-590
• /
• 2009

Leukocyte adhesion deficiency is rare inherited defect on phagocytic function resulting lack of leukocyte cell surface expression of $\beta2$ integrin molecule that are essential for leukocyte adhesion to endothelial cells and chemotaxis. Clinical features of patients with leukocyte adhesion deficiency type I include recurrent necrotic infection of the skin mucous membranes, and intestinal tract with septicemia, and omphalitis arising from delayed umbilical cord separation. Oral manifestations are severe progressive periodontitis with alveolar bone loss, periodontal pockets, and partial and total premature loss of the deciduous and permanent dentitions. We report a case of leukocyte adhesion deficiency type I in a 5-year-old child with severe periodontitis. In order to prevent local and systemic infection, we controlled periodontal disease with periodic oral prophylaxis. Oral swabs and blood cultures were perfomed for suspected infection, so that optimal measures were taken through the use of appropriate antibiotics.

• Journal of Oral Medicine and Pain
• /
• v.34 no.4
• /
• pp.341-351
• /
• 2009

There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.

• Journal of Oral Medicine and Pain
• /
• v.35 no.4
• /
• pp.259-264
• /
• 2010

The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

• Journal of Oral Medicine and Pain
• /
• v.33 no.1
• /
• pp.27-33
• /
• 2008

Candidiasis, an opportunistic infectious condition caused by the genus Candida, is the most common oral fungal infection in humans. The diagnosis of oral candidiasis can often be made based on recognition of its clinical pattern, but at times there is difficulty in making a clinical diagnosis because of its various manifestations. Several antifungal medications have been developed for managing fungal infections. Despite the availability of several effective antimycotics for the treatment of oral candidiasis, failure of therapy is not uncommon due to the unique environment of the oral cavity, where the flushing effect of saliva and the cleaning action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. In this case report, we present two patients diagnosed with chronic hyperplastic candidiasis and median rhomboid glossitis, which are known as rare forms of candidiasis. In both cases, there was a significant reduction of clinical signs and symptoms when fluconazole was prescribed after the failure of initial nystatin therapy.

• Proceedings of the IEEK Conference
• /
• 2003.07c
• /
• pp.2883-2886
• /
• 2003

좋은 발성을 위하여 음성이 만들어지려면, 뇌의 언어중추의 명령에 의하여 신경망을 통하여 ‘호흡기관(폐와 흉곽. 호흡관련 근육들)’과 ‘발성기관(주로 후두 즉 성대)’ 그리고 ‘조음, 공명기관(인두, 구강 및 비강)’의 근육들이 유기적으로 작용하여야 한다. 이런 협력 체제에 문제가 생기면, 다양한 종류의 질환이 유발될 수 있다[1,2]. 현재 임상에서 음성 분석을 위해 사용되는 시스템은 대부분 성대의 진동을 측정하기 위해 stroboscopy, 전기성문파형검법 (EGG, electroglottography), 후두근전도 중의 한 방법과 음성 분석을 위한 분석 프로그램으로 구성되어 있다. 그러나, 발성은 호흡과 매우 밀접한 관계가 있어 음성, 성대의 진동, 호흡 관계를 종합적으로 관찰할 필요가 있다. 본 연구에서는 발성 시 성대 점막의 접촉 양상은 ECG 로 측정하며, 발성의 주 에너지원이 되는 호흡의 변화를 2 channel 인덕턴스 호흡감시 장치(RIP: repiratory inductive plethymography)를 이용하여 흉곽의 움직임과 상 복강의 움직임에 대하여 측정하며, 발성되는 음성은 마이크로폰을 통하여 측정하는 ‘EGG, 음성, 호흡 통합검사 장치’를 개발하였다.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1978.06a
• /
• pp.6.2-6
• /
• 1978

Granular cell myoblastoma is a rare muscular origined benign tumor which was first decribed on the vocal cord by Abrikossoff in 1931. Although this lesion is found frequently in the tongue, it has been known to occur in other parts of the oral cavity as well as in the larynx and trachea. It is of considerble clinical importance that this lesion is frequently accompanied by pseundoe-pitheliomatous hyperplasia of the overling mucosa which may easily be confused with carcinoma. We experienced a case of granular cell myoblastoma and report with the consideration of literatures concerning the same disease.

• Journal of Oral Medicine and Pain
• /
• v.35 no.1
• /
• pp.41-47
• /
• 2010

Burning mouth syndrome(BMS) is a chronic oral pain and a symptom complex disorder usually unaccomplished by mucosal lesion or other clinical and laboratory signs of organic disease. BMS is characterized by a spontaneous burning sensation that mainly affects middle-aged and postmenopausal women. The etiology of BMS is poorly understood even though evidence for a possible neuropathic pathogenesis. BMS cause from various local or systemic factor, including nutritional deficiencies, hormonal change, local infection, dental procedure, dry mouth, medication and systemic disease including diabetes mellitus. Many studies suggest peripheral alteration in sensory of trigeminal nerve system. BMS patients with supertaster indicates pathologies of central and peripheral nerve system induced by an alteration in the taste system at the level of chorda tympani and glossopharyngeal nerve. The author discuss our current understanding of etiology and pathogenesis of BMS that refered chronic oral pain.

• Journal of Oral Medicine and Pain
• /
• v.35 no.4
• /
• pp.245-258
• /
• 2010

Smoking has been identified not as a major risk factor for circulatory and respiratory diseases but also as causes of various oral diseases. A number of clinical studies and regional health surveys have found an association between smoking and poor oral health status and between smoking and prognosis of dental treatments. However, there is few studies about status of smoking cessation treatment and policies in dentistry in Korea. The purpose of this study was to investigate the smoking patterns of outpatients and outcomes of short-term smoking cessation treatment in dental hospitals in Korea and, subsequently, to seek further smoking cessation services in dentistry. This study was sponsored by Korean Dental Association (KDA) and department of culture and welfare. 825 dental patients were voluntarily participated in a 4-week smoking cessation program with nicotine patch and 297 participants of them completed on smoking-related questionnaires. All participants were recruited from outpatients of 11 dental university hospitals (primarily in the department of oral medicine, oral surgery and periodontology) in Korea during 3-month period from October 2009 to January 2010. The Questionnaires included demographics, duration of smoking, heavy smoking index (HSI), number of thinking of quit smoking, duration of stop smoking and reasons to smoking, awareness of smoking effects on oral health, and their success rate after 4 weeks of nicotine patch program was investigated. The statistical analysis was carried by SPSS version 18.0 program and Chi-square test. According to the results of this study, male in their 30s to 50s were the most prevalent of all the participants and duration of smoking increased with age. Attempt rate to quit smoking (Quit smoking) was the highest in 30s and 40s with duration of quit smoking ranging 1 to 3 months. Emotional stresswas the most frequently reported reason for smoking, followed by habit and pleasure in order. All age group showed high HIS over 71% and awareness of smoking effects on oral diseases such as oral soft tissue diseases, periodontal diseases and dental caries was found relatively high (50~60%) Periodontal implant was the main reason for participation in the smoking cessation services in dental clinics and the success rate of, 4-week nicotine patch program of all the participants was 29.4%, extremely low compared to that of medical clinics. Systemic education for dentists to be able to provide interventions to quit smoking including counseling with the 5As'and development of available measures for smokers is needed as considered that the low success rate of the smoking cessation services in dentistry could be explained mainly by lack of dentists' strategies, experience and attention. Awareness and attention of dentists should be emphasized and their participation be encouraged by long-term, multidisciplinary policies such as establishment of insurance fee, which would made a considerable progress in preventing smoking-related oral diseases and promoting public oral health.

• Journal of Oral Medicine and Pain
• /
• v.24 no.3
• /
• pp.245-257
• /
• 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.

• Korean Journal of Head & Neck Oncology
• /
• v.30 no.1
• /
• pp.15-19
• /
• 2014

비인두암에서 시행되는 방사선 치료 이후에 구강건조증과 피부 변화는 흔하게 볼 수 있는 합병증 중 하나이다. 비인두암의 좋은 예후를 고려할 때, 그러한 치료와 관련된 독성들은 상대적으로 오랫동안 문제를 야기하며 삶의 질 저하를 불러온다. 특히 류마티스 관절염, 루푸스와 같은 결합조직 질환을 가진 환자들에게서 방사선 치료를 시행하였을 때, 빈번하게 심각한 독성이 관찰된다. 본 증례는 성인형 스틸씨 병에서 병발된 비인두암의 치료로 항암방사선 동시치료를 실시한 결과, 비교적 경미한 구강 건조, 점막염, 불면증 등의 합병증이 관찰되었으나, 완전 관해가 획득되었다. 이에 저자들은 과거에 보고된 적 없는 성인형 스틸씨 병에 병발한 비인두암의 치료 경험을 다른 결합조직질환들에서 방사선 치료의 문헌들과 함께 보고하는 바이다.