The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Consensus ; Humans ; Oral Ulcer/therapy*

ABSTRACT Salmon skin extract contains high proline and hydroxyproline, and has been suggested as a potential topical agent for traumatic oral ulcer healing. The aim of this study was to evaluate the effect of salmon skin extract as traumatic oral ulcer healing. A total of 32 Wistar rats (200 g to 250 g) were distributed into four groups. Group 1 served as the control group (no treatment), Group 2 was topically treated with salmon skin extract agent 4%, Group 3 was topically treated with salmon skin extract agent 5%, and Group 4 was topically treated with salmon skin extract agent 6%. Traumatic ulcers at lip mucosa were performed in all rats and 0.1 ml salmon skin extract was applied on the ulcer twice daily for seven days. The animals were euthanised on the last day of treatment. Biopsy specimens were taken from the lip mucosa in all rats for epithelial thickness evaluation and the study for number of fibroblasts by histological analysis. Significant increase in epithelial thickness and the number of fibroblasts (p > 0.05) was observed in salmon skin extract treatment groups as compared to the control group. Salmon skin extract 6% treatment group had the highest epithelial thickness and the number of fibroblasts amongst the study groups. Salmon skin extract promises an innovative topical application treatment for traumatic oral ulcer healing. Salmon skin extract 6% was the most effective concentration for traumatic oral ulcer healing.
Epithelial Cells ; Fibroblasts ; Oral Ulcer--therapy

OBJECTIVETo compare therapeutic effects of acupuncture and routine western medicine is an recurrent oral ulcer of the type of accumulation of heat in the heart and spleen.

METHODSSeventy-four cases were randomly divided into 2 groups. The acupuncture group of 37 cases were treated with acupuncture at Tongli (HT 5), Gongsun (SP 4), Neiting (ST 44), Hegu (11 4), etc. The control group of 37 cases were treated with VitB2 , VitC. Their therapeutic effects were compared.

RESULTSThe total effective rate was 83.8% in the treatment group and 48.6% in the control group with a very significant difference between the two groups (P<0.01).

CONCLUSIONThe therapeutic effect of acupuncture is significantly better than that of the control group, and acupuncture is an effective therapy for recurrent oral ulcer of type of accumulation of heat in the heart and spleen.

OBJECTIVETo find out an effective method for treatment of oral ulcer in the premenstrual period.

METHODSSeventy-nine cases were randomly divided into a treatment group (n=48) and a control group (n=31). They were treated by acupuncture and moxibustion plus Chinese medicine and simple Chinese medicine, respectively. Their therapeutic effects were observed.

RESULTSThe effective rate was 91.7% in the treatment group and 64.5% in the control group with a significant difference between the two groups (P < 0.05).

CONCLUSIONAcupuncture and moxibustion combined with Chinese medicine has a better therapeutic effect on oral ulcer in the premenstrual period.

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.
Dataset ; Deglutition Disorders ; Drug Therapy ; Exudates and Transudates ; Hematopoietic Stem Cell Transplantation ; Humans ; Hygiene ; Inflammation ; Mucositis ; Nursing Records ; Oral Health ; Oral Hygiene ; Oral Ulcer ; Specialization ; Tertiary Care Centers

Behcet's disease is particularly prevalent in "Silk Route" populations, but it has a global distribution. The diagnosis of the disease is based on clinical criteria as there is as yet no pathognomonic test, and mucocutaneous lesions, which figure prominently in the presentation and diagnosis, may be considered the diagnostic hallmarks. Among the internationally accepted criteria, painful oral and genital ulcers, cutaneous vasculitic lesions and reactivity of the skin to needle prick or injection (the pathergy reaction) are considered hallmarks of Behcet's disease, and often precede other manifestations. Their recognition may permit earlier diagnosis and treatment, with salutary results. This paper describes the various lesions that constitute the syndrome and focuses on those that may be considered characteristic.
Behcet Syndrome/drug therapy/*pathology ; Female ; Humans ; Male ; Oral Ulcer/drug therapy/pathology ; Skin Ulcer/drug therapy/pathology ; Thrombophlebitis/drug therapy/pathology

The incidence of oral complications among adult cancer patients undergoing chemotherapy varies from 12 to 80%. Adequate oral hygiene has been shown to be important in prevention of oral complication and an essential role is reserved for the nursing staff. These considerations prompted the decision to survey by means of a questionaire, the nurses who give care to cancer patients. The Questions were included multidisciplinary treatment, inspection skill, nursing intervention, nursing education, problem in mouth care, solution for problem solving. Results are follow : 1. A total of 116 the nurses returned the questionaire. 2. According to 88.2% of the respondents, the policy with regard to oral hygine in determined by the physician and the nurse. 62.1% of nurses do not consult the dentist When oral complication is occurred. 3. In only 34.5% of case was a penlight used to provide the necessary extra illumination nursing Inspection of oral cavity. 4. Frequency of oral complication observed by the respondents is that they observed complications in < 25% of patients. The nature of the complication varied from ulcer, stomatitis, infection, dry mouth, candidiasis, herpes simplix, bleeding. 5. Percentages of respondents who use the intervention indicated 1) to prevent oral complication : 0.9% normal saline gargling(44%), 0.02% chlorhexidine gargling, oral dressing(38.8%), observation, nutrition, restriction of alcohol and tabaco(23.2%) 2) to deal with the early symptoms : 0.9% normal saline gargling(47.4%), cryotherapy(37.9%), 0.02% chlorhexidine gargling(20.7%) 3) to help alleviate severe complications : dental consult, holding the chemotherapy(34.5%), 0.9% normal saline gargling(31.1%), cryotherapy(18.0%) 6. According to 70% of the respondents, insufficient attention is given to oral complication during nursing education classes only 8.6% said that both the theory and the practical aspects had been deal with in sufficient detail during their training. The results of the survey indicate that oral care in cancer patients undergoing chemotherapy has a number of problem. There are not enough dentist to provide the necessary care for patients undergoing chemotherapy. The expertise of the nurses with respect to the pathogenesis of the complication is limited. In the training of nurses, additional attention to oral examinations and oral hygine is warranted. The care of patients should be the responsibility of a multidisciplinary team approach. The nurse occupies a key position with in this team, which includes the medical oncologist, a dentist.
Adult ; Candidiasis ; Chlorhexidine ; Surveys and Questionnaires ; Dentists ; Diagnosis, Oral ; Drug Therapy* ; Education, Nursing ; Hemorrhage ; Humans ; Incidence ; Lighting ; Mouth* ; Nursing ; Nursing Staff ; Oral Hygiene ; Problem Solving ; Stomatitis ; Ulcer

Administration, Topical ; Humans ; Immunosuppressive Agents ; administration & dosage ; adverse effects ; therapeutic use ; Lichen Planus, Oral ; complications ; drug therapy ; pathology ; Oral Ulcer ; drug therapy ; etiology ; Tacrolimus ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome

A thymic carcinoma is a rare malignant neoplasm of the thymus epithelium, which can be distinguished from a benign or invasive thymoma. Contrary to a thymoma, the association of a thymic carcinoma and autoimmune disease is rare, with only a few cases having been reported. Herein, a case of thymic carcinoma diagnosed concurrently with systemic lupus erythematosus (SLE) is reported. A 49 year-old man presented at our clinic with myalgia. He was diagnosed with SLE, based on an oral ulcer, lymphopenia, and positive ANA and anti-Sm antibodies. Incidentally, a routine chest X-ray showed a large mediastinal mass. Pathological examination of the mediastinal mass revealed an undifferentiated thymic carcinoma, of WHO classification type C. Further work-up for staging showed multiple bone and lung metastases. With a palliative aim, he received systemic chemotherapy, but refused further chemotherapy after the 2nd course. Currently, the patient has not been followed up since the chemotherapy.
Antibodies ; Autoimmune Diseases ; Classification ; Drug Therapy ; Epithelium ; Humans ; Lung ; Lupus Erythematosus, Systemic* ; Lymphopenia ; Middle Aged ; Myalgia ; Neoplasm Metastasis ; Oral Ulcer ; Thorax ; Thymoma* ; Thymus Gland

The pathogenesis of acquired immune deficiency syndrome-associated recurrent oral ulcerations (AIDS-ROU) remained obscure and these was no specific treatment for it. Syndrome differentiation in traditional Chinese medicine (TCM) focus on integral regulation and has an advantage of the disease that etiology and pathogenesis remain obscure. A draft of Chinese medicine diagnosis and treatment standard procedure for AIDS-ROU was established by literature retrieval and peer review. Two questionnaires were carried out to investigate the confirmation and advice of in-group specialist to key points of the draft including diagnosis, treatment and nursing. Then the procedures were revised accordingly. The preliminary results showed the recovery rate of complete questionnaires in the 1st survey was 96%. Specialists confirmed more on outline, case history and physical examinations, syndrome differentiation of hyperactivity of fire due to Yin deficiency syndrome (HFYDS), treatment of heat accumulated in heart and spleen syndrome (HAHSS) and HFYDS, treatment of western medicine and nursing. They held different opinions on incidence, treatment of deficiency of spleen-QI and stomach-QI syndrome (DSSS) and criterion of therapeutical evaluation. Cronbach coefficient alpha (CCA) was 0.998 and split-half reliability R was 0.91. Recovery rate of complete questionnaires in 2nd survey was 100%. Specialists confirmed more on outline, etiology and pathogenesis, case history and physical examination, auxiliary examination, diagnostic criteria, syndrome differentiation and treatment of HAHSS and HFYDS. They held different opinions on syndrome differentiation and treatment of intermingled cold and heat syndrome and DSSS, nursing and the other therapies. CCA was 0.428 and split-half reliability R was 0.96. Coefficient of variations of the 2nd survey were less than those of the 1st survey, which mean coordination was improved. Each single item in two surveys contributed less difference in overall results according to weight coefficients. A new revision of the procedure was preliminarily established according to results of two surveys. Experts'activeness, concentration and coordination were good in two surveys. They had reached consensus in key points of the draft including diagnosis, treatment and nursing on the whole.
Acquired Immunodeficiency Syndrome ; complications ; Consensus ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; standards ; Oral Ulcer ; complications ; diagnosis ; therapy ; Recurrence ; Reference Standards ; Surveys and Questionnaires