Influences of Saliva Substitutes on Salivary Enzymatic Activity

고홍섭,이승우,Kho, Hong-Seop,Lee, Sung-Woo Korean Academy of Orofacial Pain and Oral Medicine 2009 Journal of Oral Medicine and Pain Vol.34 No.3

Many of the protective functions of saliva can be attributed to the biological, physical, structural, and rheological characteristics of salivary glycoproteins. Therefore, the development of ideal saliva substitutes requires understanding of the rheological as well as biological properties of human saliva. In the present study, we investigated the changes of salivary enzymatic activities by saliva substitutes and compared viscosity of saliva substitutes with human saliva. Five kinds of saliva substitutes such as Moi-Stir, Stoppers4, MouthKote, Saliva Orthana, and SNU were used. Lysozyme activity was determined by the turbidimetric method. Peroxidase activity was determined with an NbsSCN assay. $\alpha$-Amylase activity was determined using a chromogenic substrate, 2-chloro-p-nitrophenol linked with maltotriose. The pH values of saliva substitutes were measured and their viscosity values were measured with a cone-and-plate digital viscometer at six different shear rates. Various types of saliva substitutes affected the activities of salivary enzymes in different ways. Stoppers4 enhanced the enzymatic activities of hen egg-white lysozyme, bovine lactoperoxidase (bLP), and $\alpha$-amylase. Saliva Orthana and SNU inhibited bLP activity and enhanced $\alpha$-amylase activity. MouthKote inhibited $\alpha$-amylase activity. Moi-Stir inhibited the enzymatic activities of bLP and $\alpha$-amylase. The pH values were very different according to the types of saliva substitutes. Stoppers4, MouthKote, and Saliva Orthana showed lower values of viscosity at low shear rates and higher values of viscosity at high shear rates compared with unstimulated and stimulated whole saliva. Moi-Stir and SNU displayed much higher values of viscosity than those of natural whole saliva. Collectively, our results indicate that each saliva substitute has its own biological and rheological characteristics. Each saliva substitute affects the enzymatic activity of salivary enzyme and finally oral health in different ways.

이갈이의 진단과 치료

고홍섭,Kho, Hong-Seop 대한수면의학회 2005 수면·정신생리 Vol.12 No.1

Bruxism is defined as 'diurnal or nocturnal parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth'. Bruxism and clenching are two of the most common contributing factors in patients with temporomandibular disorders and craniofacial pain disorders. Even though many studies report the high prevalence of bruxism, its cause is still not clear. Occlusal interference has been regarded as a major etiologic factor. Nowadays, psychological stress and sleeping disorders are generally regarded as major possible etiologic factors. More than likely, the cause is multifactoral and overlapping, which makes it difficult for the practitioner to apply comprehensive and effective management strategies. Although dentists and psychologists generally believe that effective treatment is best achieved with a better understanding of the etiology of a given disorder, for now treatment for this type of disorder must proceed without a clear understanding of etiology. To overcome this obstacle, evidence-based comprehensive management protocols based on accumulated scientific findings should be provided. In this presentation, epidemiology, etiology, and the characteristics of bruxism are reviewed. Diagnostic procedures and management strategies focused on occlusal appliances and behavioral approaches are also discussed.

구강점막 상피세포에 부착하는 타액 성분

고홍섭,Kho, Hong-Seop 대한안면통증구강내과학회 1999 Journal of Oral Medicine and Pain Vol.24 No.3

The present investigation was carried out to identify salivary components of mucosal pellicle and to explore the difference of mucosal pellicle components according to the location of oral mucosa. By using antisera and immunoblotting, high-(MG1) and low-(MG2) molecular-mass salivary mucins, amylase, IgA, proline-rich proteins(PRPs) were detected in mucosal pellicle in vivo. In addition, the data indicated that mucins, IgA and proline-rich proteins could be cleaved into lower-molecular-mass products, whereas the IgA, proline-rich proteins could also be cross-linked into higher-molecular-mass complexes. Mucosal pellicles from buccal, labial and palatal mucosa showed similar pattern in immunoblotting experiments using anti-MG2 and anti-PRPs antisera. The data from this study suggest that during mucosal pellicle formation multiple components of saliva adsorb to oral mucosal epithelial cell surfaces, and selected components can be proteolytically cleaved into smaller fragments and/or cross-linked into higher-molecular products.

구강 질환 진단용 제제

고홍섭,Kho, Hong-Seop 대한안면통증구강내과학회 1999 Journal of Oral Medicine and Pain Vol.24 No.2

The most important progress in diagnostic sciences is the increased sensitivity and specificity in diagnostic procedures due to the development of newer micromethodologies and increasing availability of immunological and molecular biological reagents. The outcome of researches in this field has already provided DNA probes and antibodies which can be used for diagnosing various kinds of diseases including inherited ones. This development can be also applied to diagnose diseases in oral and maxillofacial regions. Technological advances have yielded highly sensitive test methodologies so that low analyte concentration and small sample volume are no longer limiting factors. Therefore, saliva can be useful test fluid for an array of analytes. Salivary constituents of diagnostic significance include steroid hormones, antibodies, drugs, and tumor markers. Of the proteins present in saliva, viral-specific immunoglobulins are of the greatest diagnostic interest. The development of conjugates and antigens by recombinant DNA technique and peptide synthesis is necessary for clinical application. Several kits developed for the purpose of blood testing should be modified to permit their application to saliva. The final practical outcome of researches in diagnostic sciences will be various diagnostic agents which can be used for detection of bacteria and viruses, screening and diagnosis of diseases, genetic screening for forensic individual identification. For these purposes, collaboration researches and development between institutions and companies are essential.

노인 환자의 치과 치료시 고려 사항

고홍섭(Hong-Seop Kho) 대한치과의사협회 2011 대한치과의사협회지 Vol.49 No.10

The geriatric population is the most rapidly growing part of the general population, which leads to an increase of chronic conditions and illnesses that will influence both oral and systemic health. The most common chronic diseases in elderly population are arthritis, hypertension, heart diseases, diabetes, and cognitive impairment. Chronic impairments such as visual, hearing, orthopedic, and speech disorders are also prevalent among older adults. All these chronic conditions have potential oral complications and the treatments of systemic diseases also has implications for the maintenance of oral health. Therefore, oral health care professionals should catch up with increasing knowledge in this field and can modify the treatment strategy for older adults. In addition, oral health care professionals should understand the changing need of oral health problems in this age and prepare the future demand.

Factors Related to Patients' Satisfaction Level of Treatment Outcome of Oral Malodor

이정윤,고홍섭,김영구,정성창,이승우,Lee, Jeong-Yun,Kho, Hong-Seop,Kim, Young-Ku,Chung, Sung-Chang,Lee, Sung-Woo The Korean Academy of Orofacial Pain and Oral Medi 2001 Journal of Oral Medicine and Pain Vol.26 No.1

본 연구에서는 환자들에 의해 구취와 관련이 있다고 일반적으로 믿어지고 있는 여러 요인들이 치료 후의 환자의 만족도에 미치는 영향에 대해 알아봄으로써 환자의 만족도의 예후를 판단할 수 있는 자료를 마련하고자 하였다. 서울대학교 치과병원 구강진단과에 구취를 주소로 내원한 환자 194명을 대상으로 설문지를 이용하여 구취와 관련성이 있는 것으로 알려져 있는 항목들을 조사하였다. 조사 항목으로는 1) 본인확인가능여부, 2) 타인확인가능 여부, 3) 구취의 기간, 4) 구취의 빈도, 5) 축농증, 6) 비염, 7) 코수술 병력, 8) 콧물이 목뒤로 넘어감, 9) 코막힘, 10) 비호흡 곤란, 11) 구강건조감, 12) 편도선부종, 13) 가래, 14) 신물의 역류, 15) 소화불량, 16) 흡연여부가 포함되었다. 구취의 평가는 portable sulfide monitor인 $Halimeter^{(R)}$(Interscan Co., Chatsworth, CA, USA)를 이용하여 치료 전, 후에 각각 측정하였고, 혀배면의 세정, 치면 세균막 조절, 0.25% $ZnCl_2$ 양치액의 사용을 내용으로 하는 구취의 치료를 시행한 뒤 자신의 구취개선정도에 대해 %로 질문하여 치료 후 만족도를 조사하였다. 각 조사 항목과 치료 후 만족도 사이의 상관관계 및 실제 $Halimeter^{(R)}$ 수치의 개선정도와 만족도 사이의 상관관계를 분석하였으며, Symptom Checklist - 90 Revised(SCL-90R)의 분석결과에 따라 환자를 두 그룹으로 분류하고 두 그룹 사이의 치료 후 만족도의 차이를 조사한 결과 다음과 같은 결론을 얻었다. 1. 본인 및 타인 확인가능여부, 구취가 항상 나는지 여부, 구취의 기간, 축농증, 비염, 코수술 병력, 코막힘, 비호흡 곤란, 콧물이 목뒤로 넘어감, 흡연여부에 따른 치료 후 만족도의 유의한 차이는 없었다. 2. 신물의 역류(p=0.003), 소화불량(p=0.007), 구강건조감(p=0.016), 편도선 부종(p=0.018), 가래(p=0.033)에 따른 치료 후 만족도는 통계적으로 유의한 수준의 차이를 보였다. 3. $Halimeter^{(R)}$ 수치의 개선정도와 만족도 사이의 유의한 상관관계는 관찰되지 않았다(r=0.092, p=0.201).

간 이식 예정 환자의 구강건강상태 및 치과치료 요구도에 관한 연구

박태준,고홍섭,Park, Tae-Jun,Kho, Hong-Seop 대한안면통증구강내과학회 2009 Journal of Oral Medicine and Pain Vol.34 No.1

Liver transplantation is definitive treatment for the patients suffering from hepatitis, severe liver cirrhosis and liver cancer. In these patients, systemic infections under immunosuppression may occur easily. Therefore, primary object of dental treatments before liver transplantation is absolute removal of oral infection source. In addition, comprehensive dental management plan is essential for success of liver transplantation. The present study has been performed to investigate decayed, missing and filled permanent teeth index(DMFT index), degree of oral hygiene, past medical history, need of dental treatment, completion of dental treatment need and time interval between dental visit and operation date of liver transplantation in liver transplant candidates. Obtained results were as follows; 1. Decayed teeth of the patients were 2.68, missing teeth were 4.02 and filled teeth were 3.42. DMFT index was 10.12. 2. Twenty percents of patients showed moderate to severe food impactions, 42.2% of patients had moderate to heavy calculus and 37.8% of patients displayed gingival inflammation with swelling. 3. Patients needed periodontal treatments more than any other dental treatments. Periodontal treatments were needed for 88.9% of patients, operative & endodontic treatments were 46.7% of patients and 33.3% of patients needed for oral & maxillofacial surgical treatments. 4. Among 90 patients, time interval between scheduled operation date of liver transplantation and dental visit was within 2 weeks for 32.2% of patients, within 1 week for 20.0% of patients. In conclusion, most liver transplant candidates needed dental treatments for removal of potential infection sources. However because of insufficient interval between dental visit and operation date, they had taken liver transplantation procedures without comprehensive dental management. Development of preventive and comprehensive dental management program is mandatory for these patients. Cooperative interdisciplinary management will play a positive role for successful liver transplantation.

Iridoid 화합물이 창상 치유에 미치는 영향

이승우,고홍섭,이상구,Lee, Sung-Woo,Kho, Hong-Seop,Lee, Sang-Goo 대한안면통증구강내과학회 1999 Journal of Oral Medicine and Pain Vol.24 No.2

Aucubin, the natural product, which is isolated from Aucuba japonica, has a variety of pharmacological effects such as liver-protective function, inhibition of liver RNA and protein biosynthesis, hypotensive activity and antimicrobial effect, etc. This study was performed to investigate the effects of iridoid compounds on wound healing. The author prepared 0.1% aucubin solution and 0.1% aucubin ointment as an active form, aucubigenin to which aucubin was converted by ${\beta}$-glucosidase. Artificial surgical wound was made on either 1cm lateral side of the dorsal midline along the axis of spine of Sprague-Dawley rats under sterile technique. Application of 0.1% aucubin solution or 0.1% aucubin ointment to surgical wound was done daily. Light microscopic examination was performed on the postsurgical 3 days, 5 days, and 9 days. The 0.1% aucubin solution group epithelialized earlier than the control group and the fibrosis of granulation tissue of both aucubin groups were more prominent than the control group. Collectively, this study suggests the possibility of aucubin as a topical agent. Further research should be performed on the mechanism of aucubin on wound healing and proper formulation for effective topical agents.

구강건조증 환자의 임상적 특징에 관한 연구

오정규,김연중,고홍섭,Oh, Jeong-Kyu,Kim, Youn-Joong,Kho, Hong-Seop 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.4

Advances in medical procedures and utilization of medication have resulted in expanding aged population, which leads to increased aged patients with salivary hypofunction and its associated symptoms in dental clinic. The purpose of this study was to investigate clinical characteristics of patients with dry mouth and its correlation with their salivary flow rate. Forty dry mouth patients (7 males, 33 females, mean age 42.0 years) whose flow rate of unstimulated whole saliva was less than 0.15 ml/min were included and their gender- and age-matched controls (7 males, 33 females, mean age 42.9 years) who did not report any complaints, suggestive of salivary gland dysfunction and had the flow rate of greater than 0.20 ml/min were included for comparison. The salivary flow rate was measured in both unstimulated and stimulated conditions. Dry mouth-related clinical information including history, dry mouth associated symptoms, exacerbating and relieving factors, drugs, systemic diseases, and family history was investigated using questionnaires. The differences in distribution of patients and control subjects to each question and their relation to the salivary flow rate were analyzed and we came to following conclusions. 1. There were statistically significant differences in the distribution of patients and controls to the following questions: the period and frequency of suffering from dry mouth; severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods, severity of discomfort in usual life due to dry feeling; self-assessment of residual salivary volume; taking medications. 2. The patients had more stress-related medical histories including indigestion, insomnia, and gastritis compared with controls. The patients took many kinds of medications to control their systemic diseases. 3. There were statistically significant differences in the salivary flow rate between different groups of patients to following questions: severity of dry feeling during a meal; severity of discomfort during swallowing; necessity of sipping liquids during swallowing dry foods. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one. 4. The salivary flow rate of patients taking medications was significantly less than that of patients who did not take medications. The difference was more significant in the case of stimulated salivary flow rate rather than unstimulated one.

미각 이상 환자의 미각 역치 검사에 관한 증례 보고

홍주희,오정규,고홍섭,Hong, Ju-Hee,Oh, Jeong-Kyu,Kho, Hong-Seop 대한안면통증구강내과학회 2001 Journal of Oral Medicine and Pain Vol.26 No.2

The authors performed the taste threshold tests in two patients complaining taste problem who visited the Department of Oral Diagnosis, Seoul National University Dental Hospital. The taste thresholds were determined using a concentration series of five tastants, sucrose ( sweet ), NaCl ( salty ), citric acid ( sour ), quinine hydrochloride ( bitter ) and monosodium glutamate ( umami ). The taste solutions were diluted by half quarter logarithmic steps. The two patients showed higher taste thresholds level than normal but the taste threshold results did not coincide with the patients appeal. Further researches are needed for developing simple and precise diagnostic methods which can be applied to the patients with taste disorder.