• Title/Summary/Keyword: oral mucosal diseases

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A Case of Mucous Membrane Pemphigoid: From Diagnosis to Therapeutic Strategy

  • Kang, Kun-Hwa;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.63-68
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    • 2021
  • Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

Evaluation of systemic and mucosal immune responses in mice administered with novel recombinant Salmonella vaccines for avian pathogenic Esherichia coli

  • Oh, In-Gyeong;Lee, John Hwa
    • Korean Journal of Veterinary Research
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    • v.53 no.4
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    • pp.199-205
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    • 2013
  • Avian pathogenic Escherichia coli (APEC) is a causative agent for a number of extra intestinal diseases and account for significant losses to the poultry industry. Since protective immunity against APEC is largely directed to virulence antigens, we have individually expressed four different viulence antigens, papA, papG, IutA, and CS31A, using an attenuated Salmonella Typhimurium and a plasmid pBB244. Following oral immunization of mice with combination of two or four of these strains, serum IgG and mucosal IgA responses were elicited against each antigen represented in the mixture. The antigen-specific mucosal IgA responses were significantly higher in the group of mice immunized with the heat-labile Escherichia coli enterotoxin B subunit (LTB) strain than those in the group of mice immunized without the LTB strain. While, there was no significant difference between these two groups in antigen-specific serum IgG responses. The results showed that LTB could act as mucosal immune adjuvant. To assess the nature of immunity, the distribution of antigen-specific IgG isotypes was analyzed. All groups promoted Th1-type immunity as determined by the IgG2a/IgG1 ratio. Thus, our findings provided evidence that immunization with a combination of several vaccine strains is one of the strategies of developing effective vaccines against APEC.

Early wound healing of the hard-palate mucosal harvest site using artificial dermis fixation by a transparent plate

  • Suzuki, Yushi;Tanaka, Ichiro;Sakai, Shigeki;Yamauchi, Tomohiro
    • Archives of Plastic Surgery
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    • v.48 no.2
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    • pp.208-212
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    • 2021
  • Background There are currently no guidelines for the postoperative wound management of the hard-palate donor site in cases involving mucosal harvesting. This study describes our experiences with the use of an artificial dermis for early epithelialization and transparent plate fixation in cases involving hard-palate mucosal harvesting. Methods A transparent palatal plate was custom-fabricated using a thermoplastic resin board. After mucosal harvesting, an alginic acid-containing wound dressing (Sorbsan) was applied to the donor site, which was then covered with the plate. After confirming hemostasis, the dressing was changed to artificial dermis a few days later, and the plate was fixed to the artificial dermis. The size of the mucosal defect ranged from 8×25 to 20×40 mm. Results Plate fixation was adequate, with no postoperative slippage or infection of the artificial dermis. There was no pain at the harvest site, but a slight sense of incongruity during eating was reported. Although the fabrication and application of the palatal plate required extra steps before and after harvesting, the combination of the artificial dermis and palatal plate was found to be very useful for protecting the mucosal harvest site, and resulted in decreased pain and earlier epithelialization. Conclusions The combination of artificial dermis and a transparent palatal plate for wound management at the hard-palate mucosal donor site resolved some of the limitations of conventional methods.

A Case Report on Oro-Facial Manifestations in Leukemia (Oral Chronic GVHD) (백혈병 환자의 구강악안면 증상 발현에 관한 증례보고 (Oral Chronic GVHD))

  • Ahn, Hyoung-Joon;Kwon, Byung-Ki;Shin, Kyoung-Jin;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.159-165
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    • 2000
  • Subsequent to an allogenic stem cell transplantation(ASCT) on patients with hematologic malignancy(AML, ALL, CML, multiple myeloma, lymphoma etc.), chronic GVHD(graft versus host disease), which is an immunological reaction, occurs. With treatment results from patients who were diagnosed with ALL(acute lymphocytic leukemia), undergone BMT(bone marrow transplantation) and showed oral and skin lesions due to GVHD, treatment of oral manifestations of leukemia and its general management were studied. 90% of patients with chronic GVHD show change in the oral mucosa causing oral manifestations such as leukoplakia, lichenoid change of the oral mucosa, mucosal atrophy, erythema, ulceration and xerostomia. In treating GVHD, extensive systemic immunosuppression cause bacterial, viral, fungal infection that are fatal, and even if the treatment is successful, the patient is already in a severe immunosuppressed state. Therefore, localized target therapy is preferred. In another words, topical application(rinse, cream, ointment etc.) of cyclosporin and steroid in treating oral chronic GVHD is highly recommended, and the use of PUVA(Psoralen Ultraviolet A) and thalidomide is reported to be effective. In treating such diseases, dental treatment to control pain and prevent secondary infection of oral manifestations is very important. To those patients with systemic diseases who show limited effect by general dental treatment, non-invasive treatment such as the dental laser, in addition to the use of drugs, may be necessary to actively treat pain and help the healing process. For greater results, new effective methods are to be developed for treatment.

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Oral Vancomycin Therapy in a Child with Primary Sclerosing Cholangitis and Severe Ulcerative Colitis

  • Buness, Cynthia;Lindor, Keith D.;Miloh, Tamir
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.210-213
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    • 2016
  • Primary sclerosing cholangitis (PSC), a rare progressive liver disease characterized by cholestasis and bile duct fibrosis, has no accepted, effective therapy known to delay or arrest its progression. We report a 15 year old female patient diagnosed with PSC and moderate chronic active ulcerative colitis (UC) who achieved normalization of her liver enzymes and bile ducts, and resolution of her UC symptoms with colonic mucosal healing, after treatment with a single drug therapy of the antibiotic oral vancomycin. We postulate that the oral vancomycin may be acting both as an antibiotic by altering the intestinal microbiome and as an immunomodulator. Oral vancomycin may be a promising treatment for PSC that needs to be further studied in randomized trials.

Antidepressant-induced Burning Mouth Syndrome - A Unique Case

  • Raghavan, Shubhasini Attavar;Puttaswamiah, Rajiv Nidasale;Birur, Praveen N.;Ramaswamy, Bhanushree;Sunny, Sumsum P.
    • The Korean Journal of Pain
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    • v.27 no.3
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    • pp.294-296
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    • 2014
  • Burning Mouth Syndrome (BMS) is defined as a chronic orofacial pain syndrome, without evidence of mucosal lesions and other clinical signs of disease or laboratory abnormalities. Patients with BMS complain of burning pain in the mouth, xerostomia and taste disturbances. It is more common among women and the median age of occurrence is about 60 years. BMS may be primary or secondary to other diseases. The mainstay in the treatment of BMS includes antidepressants, benzodiazepines, and anticonvulsants. A few cases of BMS caused due to medication have been reported. The causative drugs include angiotensin-converting enzyme inhibitors, anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines. This is a case report of a patient on antidepressants who developed symptoms of BMS thereby causing a dilemma in management.

Improving Effects with Upper Gastrointestinal Diseases Treated with Brown Rice and Germinated Brown Rice (현미와 발아현미의 상부 위장관 보호 효능)

  • Lee, AhReum;Kim, SungHyun;Kwon, OJun;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.31 no.5
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    • pp.85-92
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    • 2016
  • Objectives: This study is experimental comparison of brown rice (BR) and germinated brown rice (GBR) on upper gastrointestinal diseases animal models.Methods: The ICR mice were divided randomly into four groups of six animals each (Normal mice, gastritis mice, gastritis mice treated with BR, gastritis mice treated with 48h GBR). Gastritis was induced by administration of 0.5 mL 150 mM HCl-60% ethanol. Six-week-old male Sprague-Dawley (SD) rats were randomly divided into 7 groups after 1 week adaptation. (Normal rat, reflux esophagitis (RE) rat, RE rat treated with BR, RE rat treated with 24,30,36,48h GBR). Reflux esophagitis was induced by ligation with a 2-0 silk thread both the pylorus and the transitional junction between the forestomach and the corpus in SD rats.Results: HCl/ethanol-induced gastric mucosal injury mice were ameliorated mucosal damage upon histological evaluation by treatment of 48h GBR than BR. Optical changes such as hyperemia and multiple erosions were observed in the rats with RE and damage to the normal rats was not apparent. The oral administration of GBR significantly diminished against gross mucosal damage in a germination time-dependent manner. Also, the administration of GBR suppressed the biomarker of oxidative stress, reactive oxygen species (ROS) and produces peroxynitrite (ONOO-) in serum. However, the administration of GBR could not affect to the pH level secreted from stomach when compared with Control group.Conclusions: These findings suggest that GBR could have improving effects on upper gastrointestinal diseases in a germination time-dependent manner.

Oral Manifestation of Paraneoplastic Pemphigus

  • Kim, Seurin;Park, In Hee;Park, YounJung;Kwon, Jeong-Seung;Choi, Jong-hoon;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.44 no.3
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    • pp.118-122
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    • 2019
  • Paraneoplastic pemphigus (PNP) is a rare and often fatal autoimmune blistering disease accompanied by both benign and malignant neoplasms. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by PNP patients. Oral ulcers are initial lesions in various autoimmune diseases like pemphigus, bullous pemphigoid, erythema multiforme, graft-versus-host, lichen planus, it does not improved despite of high-dose steroid therapy. We report a-35-year-old female who presented oral ulceration, lip crust and skin lesions. By doing several examinations, such as enzyme-linked immunosorbent assay, incisional biopsy with indirect immunofluorescence, she was diagnosed PNP with non-Hodgkin's lymphoma on pancreas.

Comparison of Antimicrobial Activity of Electrolyzed Water Using Various Electrodes against Biofilm of Oral Pathogens

  • Yoo, Yun S;Shin, Hyun-Seung;Lee, Sung-Hoon
    • International Journal of Oral Biology
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    • v.40 no.3
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    • pp.135-141
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    • 2015
  • Biofilms of oral microbes can cause various diseases in the oral cavity, such as dental caries, periodontitis and mucosal disease. Electrolyzed water generated by an electric current passed via water using a metal electrode has an antimicrobial effect on pathogenic bacteria which cause food poisoning. This study investigated the antimicrobial activity of electrolyzed waters using various metal electrodes on the floatage and biofilms of oral microbes. The electrolyzed water was generated by passing electric current using copper, silver and platinum electrodes. The electrolyzed water has a neutral pH. Streptococcus mutans, Porphyromonas gingivalis and Tannerella forsythia were cultured, and were used to form a biofilm using specific media. The floatage and biofilm of the microbes were then treated with the electrolyzed water. The electrolyzed water using platinum electrode (EWP) exhibited strong antimicrobial activity against the floatage and biofilm of the oral microbes. However, the electrolyzed water using copper and silver electrodes had no effect. The EWP disrupted the biofilm of oral microbes, except the S. mutans biofilm. Comparing the different electrolyzed waters that we created the platinum electrode generated water may be an ideal candidate for prevention of dental caries and periodontitis.

Erythema Multiforme and Stevens-Johnson Syndrome : Case Reports (다형홍반과 스티븐스-존슨 신드롬의 증례보고)

  • Jung, Won;Lee, Kyung-Eun;Byun, Jin-Seok;Suh, Bong-Jik
    • Journal of Oral Medicine and Pain
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    • v.36 no.4
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    • pp.207-213
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    • 2011
  • Painful, ulcerative lesions of various systemic disease can affect the oral mucosa membrane at first. If you don't consider the skin lesion, followed or accompanied by oral mucosa, you are likely to fail in differential diagnosis. In this cases, we introduced erythema multiforme and Stevens-Johnson syndrome(SJS) patients with painful, ulcerative lesions on oral mucosa and skin. Also we review oral mucosal diseases come with the skin lesions.