• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.46-56
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• 2019

Purpose : The purpose of this study was to identify minimum data sets for oral mucous integrity-related documentation and to analyze nursing records for oral care. Methods: To identify minimum data sets for oral status, the authors reviewed 26 assessment tools and a practical guideline for oral care. The content validity of the minimum data sets was assessed by three nurse specialists. To map the minimum data sets to nursing records, the authors examined 107 nursing records derived from 44 patients who received chemotherapy or hematopoietic stem cell transplantation in one tertiary hospital. Results: The minimum data sets were 10 elements such as location, mucositis grade, pain, hygiene, dysphagia, exudate, inflammation, difficulty speaking, and moisture. Inflammation contained two value sets: type and color. Mucositis grade, pain, dysphagia and inflammation were recorded well, accounting for a complete mapping rate of 100%. Hygiene (100%) was incompletely mapped, and there were no records for exudate (83.2%), difficulty speaking (99.1%), or moisture (88.8%). Conclusion: This study found that nursing records on oral mucous integrity were not sufficient and could be improved by adopting minimum data sets as identified in this study.

• Radiation Oncology Journal
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• v.24 no.1
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• pp.67-76
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• 2006

Purpose: Oral mucositis is a common toxicity of radiation or chemotherapy, which is used a treatment for head and neck cancer. We investigated effects of recombinant human epidermal growth factor (rhEGF) on radiation-induced oral mucositis in rat model. Materials and Methods: Spraque-Dawley rats (7 per group) exposed to a single dose of 25 Gy (day 0) on their head, except for one group, were randomly divided into un-treated, vehicle-treated, and two rhEGF-treated groups. Rats were topically applied with rhEGF (15 or $30{\mu}g/oral$ cavity/day) or vehicle to their oral mucosa. Survival rate of rats, weight changes, and food intakes were examined from day 0 to 18 after radiation. Histology study was performed from oral mucosa of rats at day 7 and 18 after radiation. Results: rhEGF-treated groups (15 or $30{\mu}g/oral$) showed all survival rate 33%, whereas un-treated and vehicle-treated groups showed all survival rate 0% at the end of experiment. rhEGF-treated groups statistically had less weight loss compared to vehicle-treated group from day 2 to 7 after radiation. Food intake of rats with rhEGF treatment turned to increase at day 14 after radiation. At 7 day after radiation, un-treated and vehicle-treated groups showed severe pseudomembraneous or ulcerative oral mucositis. On the other hand, rhEGF-treated groups had no more than cellular swelling and degeneration of epidermal cells in oral mucosa of rats. Conclusion: These results suggest that rhEGF has significantly positive effects on radiation-induced oral mucositis in rats. rhEGF display a therapeutic potential on a clinical level.

• Journal of Oral Medicine and Pain
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• v.42 no.4
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• pp.116-124
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• 2017

Purpose: Burning mouth syndrome (BMS) is a disabling pain that mostly occurs in elderly women, but rarely in men. It is characterized by an unremitting oral burning sensation and pain without detectable oral mucosal changes. We investigated the clinical and hematologic features of middle-aged men with BMS, and compared the results to those of men with oral mucositis. Methods: Five men with BMS ($48.60{\pm}6.19years$) and five age-matched controls with oral mucositis ($49.80{\pm}15.26years$) underwent clinical and psychological evaluations and blood tests. Psychological status was evaluated using the Symptom Checklist-90-Revised. Cortisol, estradiol, progesterone, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), adrenocorticotropic hormone (ACTH), and antidiuretic hormone (ADH) levels and erythrocyte sedimentation rate (ESR) were determined from the blood samples. Results: ADH level was significantly lower in men with BMS than in the controls. ADH levels correlated with testosterone (p<0.01), and ACTH levels strongly correlated with ESR (p<0.05). Progesterone level positively correlated with FSH and LH levels. Pain intensity on a visual analogue scale correlated with estradiol level only in men with BMS. Among psychological factors, the obsessive-compulsive disorder, interpersonal-sensitivity, and anxiety scores were higher in men with BMS than in the controls (p<0.05). However, no correlations were observed between the psychological and hematologic factors in both groups. The BMS symptoms presented only on the tongue, with the lateral border being the most prevalent area. Conclusions: Men with BMS may experience dysregulated endocrinologic or psychoneuroendocrinologic interactions, which might affect oral BMS symptoms, aggravating the severity of the burning sensation.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.413-418
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• 2016

Objective: To assess the safety and effectiveness of a mouth-rinse with G-CSF (JiSaiXin, produced by NCPC Biotechnology Co., Ltd) in treating patients with chemotherapy-induced oral mucositis (CIM). Method: A consecutive cohort of patients with advanced cancers and CIM were treated with mouth-rinse G-CSF. All chemotherapy for patients with advanced cancers was adopted from regimens suggested by NCCN guidelines. The mouth-rinse with G-CSF at a dose of 150-300ug plus 100ml-500ml normal saline was started from the time of oral mucositis was confirmed and continuously used for at least 7 days as one course. After at least two courses of treatment, safety and efficacy were evaluated. Results: There were 7 female and 7 male patients with advanced cancer and CIM recruited into this study, including 5 with colorectal, 2 with lung, 1 patient with gastric, 1 with cervical and 1 with pancreatic cancer, as well as 2 patients with diffuse large B cell lymphomas, 1 with nasopharyngeal and 1 with gastric cancer. The median age was 57 (41-79) years. Grade 1 to 2 myelosuppression was observed in 3/14 patients, and Grade 4 myelosuppression in 1/14. Adverse effects on the gastrointestinal tract were documented in 5/14 patients, and were Grade 1 to Grade 3. No treatment related death was documented. Regarding CIM, the median response time to mouth rinse of G-CSF was 2 (1-5) days, and all patients with CIM demonstrated a positive response. Conclusions: Mouth-rinse with G-CSF proved to be safe and effective in treating patients with advanced cancers and CIM. However, further randomized controlled studies should be conducted to clarify the effectiveness of this treatment with other lesions.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.145-156
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• 2023

Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.4
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• pp.240-249
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• 2020

Objectives: Although the side effects of radiation therapy vary from mucositis to osteomyelitis depending on the dose of radiation therapy, to date, an experimental animal model has not yet been proposed. The aim of this study was to develop an animal model for assessing complications of irradiated bone, especially to quantify the dose of radiation needed to develop a rat model. Materials and Methods: Sixteen Sprague-Dawley rats aged seven weeks with a mean weight of 267.59 g were used. Atraumatic extraction of a right mandibular first molar was performed. At one week after the extraction, the rats were randomized into four groups and received a single dose of external radiation administered to the right lower jaw at a level of 14, 16, 18, or 20 Gy, respectively. Clinical alopecia with body weight changes were compared and bony volumetric analysis with micro-computed tomography (CT), histologic analysis with H&E were performed. Results: The progression of the skin alopecia was different depending on the irradiation dose. Micro-CT parameters including bone volume, bone volume/tissue volume, bone mineral density, and trabecular spaces, showed no significant differences. The progression of osteoradionecrosis (ORN) along with that of inflammation, fibrosis, and bone resorption, was found with increased osteoclast or fibrosis in the radiated group. As the radiation dose increases, osteoclast numbers begin to decrease and osteoclast tends to increase. Osteoclasts respond more sensitively to the radiation dose, and osteoblasts are degraded at doses above 18 Gy. Conclusion: A standardized animal model clinically comparable to ORN of the jaw is a valuable tool that can be used to examine the pathophysiology of the disease and trial any potential treatment modalities. We present a methodology for the use of an experimental rat model that incorporates a guideline regarding radiation dose.

• Herbal Formula Science
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• v.26 no.3
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• pp.267-281
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• 2018

Objective : This study's purpose was to review the clinical studies of Banha-Sasim-Tang. Method : We searched papers about Banha-Sasim-Tang using KISS, KTKP, PUBMED, Embase, Science Direct, and the key words 'Hangeshashinto', 'Ban Xia Xie Xin Tang', 'Pinellia Heart-Draining Decoction', 'Banhasasim tang' were used. Papers not matched with inclusion criteria were excluded. Results : Until today, there have been 65 studies on the Banha-Sasim-Tang. Of these, 12 studies were classified as clinical research papers. There were 4 cases of Functional Dyspepsia, 2 cases of Peptic Ulcer, 6 case of Oral mucositis induced by Anti-cancer Therapy. Conclusion : It can be seen that Banha-Sasim-Tang has established the basis for application to the purpose of functional dyspepsia, peptic ulcer and oral mucositis induced by anti-cancer therapy.

• Journal of Periodontal and Implant Science
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• v.45 no.2
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• pp.56-61
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• 2015

Purpose: The aim of this study was to evaluate the effectiveness of powered toothbrushes for plaque control in patients with peri-implant mucositis, in comparison with manual toothbrushes. Methods: This randomized, prospective, controlled, clinical parallel study compared the efficacy of manual and powered toothbrushes for plaque control in implant restorations. Patients with bleeding on probing, no residual pocket depth (as indicated by a pocket probing depth ${\geq}5mm$), and no radiological peri-implant bone loss were eligible for this study. Patients were requested to complete a questionnaire describing their oral hygiene habits. The duration and frequency of tooth brushing were recorded by subjects in order to assess their compliance. Clinical parameters, including the modified plaque index (mPI), the modified sulcus bleeding index (mSBI), and clinical photographs (buccal and lingual views) were recorded at baseline and at one-month and two-month follow-up visits. Results: Statistically significant differences between patients who used manual toothbrushes and those who used powered toothbrushes were found regarding the frequency of tooth brushing per day and the duration of brushing at one-month and two-month follow-up visits, while no statistically significant differences were found relating to other oral hygiene habits. A statistically significant difference in patient compliance for tooth brushing was found at one month, while no difference was found at two months. Statistically significant decreases in the mPI and the mSBI were observed in both groups from baseline to the one- and two-month follow-ups. The overall reduction of these parameters was not significantly different between the two groups, except for mPI reduction between baseline and one month of follow-up. Conclusions: Sonic-powered toothbrushes may be a useful device for plaque control in patients with peri-implant mucositis.

• Korean Journal of Head & Neck Oncology
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• v.27 no.1
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• pp.47-53
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• 2011

Purpose : Concurrent chemoradiotherapy(CCRT) with 3 weekly cisplatin is the standard treatment of locally advanced head and neck cancer(HNC). The aim is to evaluate the efficacy and toxicities of low-dose weekly cisplatin-based CCRT, which was devised to reduce the toxicity of CCRT. Method : We retrospectively analyzed HNC patients who received low-dose weekly cisplatin-based CCRT between 2008 and 2010. Cisplatin 35mg/$m^2$ was weekly given to all patients during radiotherapy. The efficacy was evaluated by the degree of clinical response, treatment failure and survival. The toxicity was evaluated by hematologic toxicities and oral mucositis. Results : A total of 27 patients were analyzed and median age was 59(range 31-81). The ratio of administered dose of radiotherapy and cisplatin to planned dose were 0.98 and 0.93, respectively. Complete remission and partial remission were 73% and 23%, respectively. Treatment failure was observed in 8(30%) patients. 1-year survival rate and 1-year disease free survival rate were 82% and 59%, respectively. Overall survival and progression-free survival did not reach median time. Grade 3/4 anemia, neutropenia, thrombocytopenia and oral mucositis were observed in 11%, 19%, 7% and 32% of patients, respectively. In terms of administered cycles, however, only 1-3% of grade 3/4 hematologic toxicities occurred among total 190 cycles. Severe oral mucositis were statistically associated with old age(p=0.003). Treatment failure had no statistical relation with age, pathology, primary site and stage. Conclusion : Low-dose weekly cisplatin-based CCRT seemed to deliver enough dose of cisplatin and to show low drop-out rate and good efficacy with low hematologic toxicities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.3
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• pp.169-174
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• 2002

Purpose: Irradiation in the oral cancer patients causes early and late complications such as intraoral mucositis and fibrosis, with a various expression of GM-CSF and TGF-${\beta}1$. The purpose of this study was to investigate the production of GM-CSF and TGF-${\beta}1$ by the irradiated human gingival fibroblasts cultivated with lipopolysaccharide. Materials and Methods: Irradiated (total dose, 60 Gy) human gingival fibroblasts were incubated with LPS. Culture supernatants that were collected at 24, 48, and 72 hours were assessed for GM-CSF and TGF-${\beta}1$ by enzyme-linked immunosorbent assay. Results: 1. GM-CSF production in nomal gingival fibroblasts was increased with incubation time, but decreased with incubation time in irradiated gingival fibroblasts. GM-CSF production in both normal and irradiated gingival fibroblasts induced with LPS was higher than the control. 2. TGF-${\beta}1$ production in normal gingival fibroblasts was decreased after 24 hours, but, it was increased until 48 hours in irradiated gingival fibroblasts. TGF-${\beta}1$ production in normal gingival fibroblasts exposed with LPS was higher than the control. Conversely, It was lower than the control in irradiated gingival fibroblasts exposed with LPS. Conclusion: This indicates that irradiation in gingival fibroblasts may play an important role in radiation-induced intraoral mucositis and fibrosis. However, LPS decreases the production of TGF-${\beta}1$ in the irradiated gingival fibroblasts.