• 대한한방부인과학회지
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• 제23권2호
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• pp.145-153
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• 2010

Purpose: Sjogren's syndrome is a type of autoimmune disease and characterized by the keratoconjunctivitis sicca, xerostomia, dryness of mouth & eyes and rheumatoid arthritis or another connective tissue disease. In the Traditional Korean Medicine, there is few report to diagnose and treat Sjogren's syndrome. Methods: The subject was a typical Sjogren's syndrome in 48-year old women whose complaints were dryness of mouth and eyes, severe general myalgia. The author treated her with acupuncture and herbal medicine therapy, then evaluated with MMQ score, XQS grade and VAS score on a regular basis. Results: After treatment, clinical symptoms were improved, MMQ score and XQS grade were decreased. Conclusion: The Traditional Korean Medical Therapy combined acupuncture with herbal medicine relieves the symptom of Sjogren's syndrome.

• 한국치위생학회지
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• 제15권1호
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• pp.55-62
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• 2015

Objectives: The purpose of this study was to investigate the associated factors of self-reported dry mouth in adults. Methods: A self-reported questionnaire was filled out by 249 adults in Seoul and Gyeonggi-do from June to October, 2014. The questionnaire consisted of general characteristics of the subjects, age, monthly income, smoking, alcohol drinking, and systemic diseases including systemic diseases, medication, oral health status, and stress. The question for dry mouth consisted of dryness in skin, eyes, lips, and nasal mucosa. The subjective dry mouth consisted of 6 questions measured by visual analogue scale(VAS). Cronbach's alpha was 0.881 in the study. Oral health related quality of life (OHIP-14) was adapted from Yoon. The questionnaire for OHIP-14 included functional limitation, physical pain, psychological disability, social disability, and experience in hadicap measured by Likert 5 scale. Cronbach's alpha was 0.885 in the study. Data was analyzed for a t-test, one-way ANOVA and multiple regression analysis by using SPSS(SPSS 18.0, USA) program. Results: There were positive correlations between oral health-related quality of life and self-reported dry mouth (functional limitation r=0.288, physical pain r=0.219, psychological discomfort r=0.193, physical disability r=0.280, psychological disability r=0.205, social disability r=0.224 and handicap r=0.270). In the multiple regression analysis, variation of self-reported dry mouth were positively associated with dry eyes{very often(${\beta}=0.305$)), sometimes(${\beta}=0.186$)}, dryness on lips{very often(${\beta}=0.247$), sometimes(${\beta}=0.177$)}, handicap(${\beta}=0.152$), physical disability(${\beta}=0.128$) and alcohol drinking(1-2 times/week)(${\beta}=0.116$) (p<0.001). Conclusions: Self-reported dry mouth may cause deterioration of the entire body dryness(dryness on eyes and lips), low oral health-related quality of life(handicap and physical disability) and alcohol drinking. Thus, It is necessary to develop oral health education programs to prevent and manage dry mouth in adults.

• Journal of Oral Medicine and Pain
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• 제43권4호
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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.

• Journal of Oral Medicine and Pain
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• 제44권4호
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• pp.179-182
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• 2019

Sjögren syndrome (SS) is a chronic autoimmune disease characterized by dryness of the mouth and eyes due to lymphocytic infiltration of the exocrine glands. In American European Consensus Group (AECG) criteria, abnormal salivary gland scintigraphy (SGS) result is one of the objective signs of SS and it has been proposed as a valid and non-invasive alternative approach to functional evaluation of salivary gland, especially in the case when unstimulated whole salivary flow is more than 1.5 mL in 15 minutes or other AECG criteria is unmet. Patients with SS are more likely to have the thyroid disease (TD), but this association remains controversial. We present a case of the use of SGS for diagnosis of primary SS and TD in patients with dry mouth and burning sensation of tongue. Through this case, we suggest the usefulness of salivary scintigraphy for screening TD in addition to diagnosis of SS.

• 셀메드
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• 제12권3호
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• pp.14.1-14.2
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• 2022

Currently, a 70-year-old woman started suffering from S.I joint pain from 1973 and had severe pain in the S.I joint, wrist, and elbow from 1975 to 1977, and was diagnosed with spinal tuberculosis at a general hospital. From 1978 to 1987, she suffered from chronic fatigue and insomnia, and since January 1, 1988, she was unable to get up while lying down, suffering from whole body joint, muscle pain, and fibromyalgia. In May 1989, she was also diagnosed with ankylosing spondylitis through genetic testing at the Catholic St. Mary's Hospital Rheumatology Department in Korea, and was treated with sulfasalazine, analgesic, and immunosuppressant, methotrexate, for 12 years until 1999, but none of the drugs eliminated the pain. She was hospitalized and discharged repeatedly, and continued to receive salt water poultice and exercise therapy at home, but was unable to move at all. In 2000, after biologic treatment with Remicade injection (Remsima®), she was able to walk and move, and after that, she was continuously prescribed biologics. From 2015 to 2019, Enbrel® (Etanercept) injection was prescribed once a week, but the symptoms such as severe pain (joint and muscle, fibromyalgia), scleroderma, Sjogren's syndrome (dryness of eyes, nose and mouth), difficulty swallowing, chronic fatigue, and stiff body appeared. Around January 2018, hepatic indicators were high and lymphocytes became enlarged. However, most serious injuries were highly improved after the OCNT combination therapy using active phytonutrients, anthocyanin-fucoidan nanocomplex. Therefore, for patients with such experiences, OCNT treatment is proposed as an alternative.

• IMMUNE NETWORK
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• 제21권5호
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• pp.34.1-34.16
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• 2021

Sjögren's syndrome (SS) is an autoimmune disease characterized by dryness of the mouth and eyes. The glandular dysfunction in SS involves not only T cell-mediated destruction of the glands but also autoantibodies against the type 3 muscarinic acetylcholine receptor or aquaporin 5 (AQP5) that interfere with the secretion process. Studies on the breakage of tolerance and induction of autoantibodies to these autoantigens could benefit SS patients. To break tolerance, we utilized a PmE-L peptide derived from the AQP5-homologous aquaporin of Prevotella melaninogenica (PmAqp) that contained both a B cell "E" epitope and a T cell epitope. Repeated subcutaneous immunization of C57BL/6 mice with the PmE-L peptide efficiently induced the production of Abs against the "E" epitope of mouse/human AQP5 (AQP5E), and we aimed to characterize the antigen specificity, the sequences of AQP5E-specific B cell receptors, and salivary gland phenotypes of these mice. Sera containing anti-AQP5E IgG not only stained mouse Aqp5 expressed in the submandibular glands but also detected PmApq and PmE-L by immunoblotting, suggesting molecular mimicry. Characterization of the AQP5E-specific autoantibodies selected from the screening of phage display Ab libraries and mapping of the B cell receptor repertoires revealed that the AQP5E-specific B cells acquired the ability to bind to the Ag through cumulative somatic hypermutation. Importantly, animals with anti-AQP5E Abs had decreased salivary flow rates without immune cell infiltration into the salivary glands. This model will be useful for investigating the role of anti-AQP5 autoantibodies in glandular dysfunction in SS and testing new therapeutics targeting autoantibody production.

• 사상체질의학회지
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• 제23권3호
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• pp.340-350
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• 2011

1. Objectives: This clinical study was conducted to understand the differences between Sasang constitutional types and to identify the physical symptoms presentation specific to each Sasang constitutional type. 2. Methods: In this descriptive study, 2,629 subjects (1,061 Taeeum-type, 683 Soeum-type, 885 Soyang-type) were surveyed between Nov 1, 2007 and Jul 31, 2010. The subjective symptoms experienced by the subjects were collected using a Physical Symptoms questionnaire, and the subjects were interviewed by Sasang specialists who determined the subjects' constitutional type. The data (in crude number and percentage) was analyzed on the general characteristics, Sasang constitutional type, and physical symptoms using the SPSS 17.0 software. The symptomatic presentation in men and women were analyzed on Sasang constitutional distribution using the chi-square test. 3. Results: 1) The physical symptoms specific to each Sasang constitutional type were as follows: 'frequent aphthous lesions in the oral cavity', 'lingering fatigue after sleep', 'headache', 'common cold symptoms presenting as loss of appetite or indigestion', and 'physical deterioration presenting as problems with digestion' in the Soeum type; 'physical deterioration presenting as problems in perspiration' and 'swelling and puffiness' in the Taeeum type; and 'excessive forgetfulness' in the Soyang type. 2) The physical symptoms specific to each Sasang constitutional type in men were as follows: 'Unilateral or bilateral headaches, 'frequent aphthous lesions in the oral cavity', 'common cold symptoms presenting as rhinorrhea or nasal congestion', 'common cold symptoms presenting as loss of appetite or indigestion', and 'physical deterioration presenting as problems with digestion' in the Soeum type; and 'swelling and puffiness' in the Taeeum type. 3) The physical symptoms specific to each Sasang constitutional type in women were as follows: 'common cold symptoms presenting as headaches', 'common cold symptoms presenting as loss of appetite or indigestion', 'physical deterioration presenting as problems with digestion' in the Soeum type; and 'pain in knees', 'redness of eyes', 'dryness of mouth', 'common cold symptoms presenting as coughing', 'physical deterioration presenting as problems in perspiration', 'swelling and puffiness' in the Taeeum type. 4. Conclusions: This study demonstrates that physical symptoms present in constitutional type-specific patterns. Understanding of the personal Sasang constitutional type and systematic, personalized healthcare based on constitutional typology is anticipated to contribute to improved health management strategy.

• 치위생과학회지
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• 제13권1호
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• pp.62-70
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• 2013

본 연구는 구강건조증 인식도와 관련요인을 분석하여 구강건조증 예방 및 환자관리법에 대한 기초자료를 제공하기 위하여 실시하였다. 2012년 8월 1일부터 9월 30일까지 인천 및 경기지역에 거주하는 만 30세 이상 성인 240명을 대상으로 설문조사를 시행하였으며, t검정과 일원배치분산분석 및 다중선형회귀분석을 시행한 결과 다음과 같은 결론을 얻었다. 1. 일반적 특성과 구강건조증 인식도의 관련성을 분석한 결과 51세 이상이고 직업이 없으며, 월 평균 수입이 300만원 미만이라고 응답한 집단에서 구강건조증을 더 많이 인식하였다(p<0.05). 2. 건강상태와 구강건조증 인식도의 관련성을 분석한 결과 전반적으로 구강건강이 좋지 않으며, 치아우식증과 치주질환 및 구내점막질환 증상이 2개 이상인 집단에서 구강건조증을 더 많이 인식하였다. 또한 전반적으로 전신건강이 좋지 않으며, 만성질환에 이환되고 매일 약물을 복용하는 집단, 수면상태에 만족하지 않고 절망감을 인식한 집단에서 구강건조증을 더 많이 인식하였다(p<0.05). 3. 삶의 질과 구강건조증 인식도와의 관련성을 분석한 결과 저작능력, 대화능력 및 일상활동에 문제가 있고, 통증 불편함이 있으며 불안 우울한 집단에서 구강건조증을 더 많이 인식하였다(p<0.001). 4. 전신건조감과 구강건조증 인식도와의 관련성을 분석한 결과 피부와 눈, 입술 및 비강 내 점막이 자주 건조한 집단에서 구강건조증을 더 많이 인식하였다(p<0.001). 5. 구강건조증 인식도와 연관성의 강도를 분석한 결과 구강건조증 인식도는 삶의 질($\beta$=0.436)과 가장 연관성이 높았 다. 다음은 매일 복용 약물 수($\beta$=0.239), 전신건조감($\beta$=0.200), 절망감 인식($\beta$=0.160), 구내점막질환 증상 수($\beta$=0.099)의 순으로 나타났다(p<0.05). 이상의 연구결과로 볼 때 구강건조증은 삶의 질 저하를 초래할 수 있으므로 사회적 관심이 필요하며, 특히 구강보건인력은 구강건조증의 원인이나 부작용 및 치료법 등에 대한 관심도를 더욱 높여야 할 것이다. 또한 계속구강건강관리체계의 운영을 통해 구강건조증 예방 및 완화법에 대한 교육을 더욱 강화하여야 하고, 구강건조증에 대한 환자의 느낌이나 타액분비저하로 인해 나타나는 구강 내 변화에 세심한 관심과 철저한 모니터링이 수반되어야 할 것이다.

• 치위생과학회지
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• 제13권4호
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• pp.386-392
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• 2013

본 연구는 전신질환자를 대상으로 구강건조감 인식도의 관련요인을 분석하고자 실시하였다. 경기도에서 소재하는 의원 중 편의표본추출법에 의해 선정된 3곳에 2013년 1월 16일부터 2013년 4월 15일까지 방문한 전신질환에 이환된 환자 109명을 대상으로 설문조사를 실시하였으며, t검정과 일원배치분산분석 및 다중선형회귀분석을 시행한 결과 다음과 같은 결론을 얻었다. 1. 전반적인 구강건조감 인식도를 조사한 결과 평상시 구강건조 증상이 있다고 응답한 자는 62명(56.9%)이었고, 없다는 47명(43.1%)이었으며, 구강건조가 심한 계절은 겨울이 29명(46.8%)으로 가장 높았다. 2. 전신건강상태 인식도, 건강행동과 구강건조감의 관련성을 분석한 결과 건강하지 않다고 인식하고 이환된 전신질환과 매일 복용 약물 수가 2개 이상인 집단에서 구강건조감이 더 높았다. 또한 절망감 인식 경험이 있고 구강 외 신체건조감이 높으며 코골이가 심할수록 구강건조감을 더 많이 인식하였다(p<0.05). 3. 구강건강상태 인식도와 구강건조감의 관련성을 분석한 결과 구강이 건강하지 않다고 인식하고 구내 점막 통증과 구취가 있는 집단에서 구강건조감을 더 많이 인식하였다(p<0.05). 4. 삶의 질과 구강건조감의 관련성을 분석한 결과 일상생활 장애도와 스트레스 수준이 높으며, 구취로 인해 남의 시선을 의식하고 신경을 쓰는 집단에서 구강건조감을 더 많이 인식하였다(p<0.05). 5. 구강건조감과 관련된 요인들의 연관성의 강도를 분석한 결과 구강건조감은 구취로 인한 타인의 시선의식(${\beta}=0.311$)과 가장 연관성이 높았고, 다음은 이환된 전신질환 수 (${\beta}=0.304$), 스트레스 수준(${\beta}=0.285$)의 순이었다(p<0.01). 이상의 연구결과로 볼 때 구강건조감은 원만한 사회생활과 건강을 유지하는 데 장애요인으로 작용할 수 있음을 추측할 수 있었다. 또한 구강건조감은 이환된 전신질환 수와 강한 연관성이 있는 것으로 나타났으므로 치과의료인력은 구강영역 뿐 아니라 전신질환과 치료제 등 전신에 대한 이해도를 더욱 높여야 한다. 또한 전신질환에 이환된 환자들의 구강진료시 구강건조 상태를 매회 평가하고 원인을 파악하는 등 구강건조에 대한 지속적인 모니터링이 수반되어야 할 것이다. 이러한 과정은 구강건조의 예방과 이로 인한 인한 구강 내외 합병증을 감소시킬 뿐 아니라 건강증진 및 삶의 질을 향상시키는 데 있어 긍정적인 효과를 나타낼 것으로 생각된다.