A Case of Anorexia and Drooling Improved by Targeting “Excessive Saliva Secretion” Using Bushirichuto / 日本東洋医学雑誌

A 65-year-old man, with a history of surgery for esophagogastric junction cancer in X-3, was admitted to the Department of Internal Medicine in our hospital in March for anorexia that had developed since January X. The patient was diagnosed with adhesive small bowel obstruction, and underwent surgery to relieve the obstruction in early May. However, his symptoms did not improve, and he was referred to our department in mid-June. His drooling was considered to be due to “excessive saliva secretion.” He started taking a decoction of bushirichuto for epigastric discomfort and resistance and coldness of the hands and feet. On the 5th day, he started to feel more energetic, and on the 8th day, his saliva production decreased. Furthermore, on the 12th day, his sense of taste and appetite improved. As the oral intake increased, tube feeding could be reduced and rehabilitation progressed ; from an almost bedridden state, he was able to walk continuously for 150 m with a cane. On the 29th day, he was transferred to a chronic care hospital. His weight increased from 34.1 kg, when he was referred to our department, to 39.7 kg at the discharge time. Anorexia and drooling, which had otherwise continued for 5 months, were improved within a short period of time by using bushirichuto.

Effectiveness of Kampo Medicines Against Intractable Stomatitis: A Mini-Review

Intractable stomatitis is a chronic inflammatory disease of oral mucosa, with unclear etiopathogenesis. Kampo Medicines (KMs), i.e., Japanese herbal medicines, effectively treat stomatitis. The precise effects of KMs on intractable stomatitis are not established. We present the details of several patients with intractable stomatitis who were well-treated with KMs (i.e., Inchinkoto, Orento, Goreisan, and Byakkokaninjinto). We also review the literature on the link between intractable stomatitis and KMs. KM-related anti-inflammatory and antioxidant activity may suppress intractable stomatitis. KMs may also facilitate wound healing through increased saliva secretion. KMs may therefore be useful for the treatment of intractable stomatitis.

Lifestyle, mental health status and salivary secretion rates

The relations between salivary variables, lifestyle and mental health status were investigated for 61 healthy female university students. The salivary secretion rates were significantly higher in the good lifestyle groups compared with the poor lifestyle groups. Among the 8 lifestyle items tested. "eating breakfast" and "mental stress" were significantly related to the salivary secretion rates. The present findings suggest that the acquisition of a good lifestyle is also very important from the viewpoint of the prevention of oral disease.A highly significant correlation (r=0.97; p<0.01) between the salivary cortisol levels and the cortisol secretion rates when controlled for the salivary secretion rates was also observed. This suggests that there is a high correlation between the intact salivary cortisol levels and the total cortisol quantity per unit time. Therefore, both these values can be used as a good index for the salivary cortisol determination.

Immunolocalization of AQP5 in Salivary Glands of Rat / 대한해부학회지

Exocrine glands secrete large volumes of fluid in response to neural or hormonal stimulation. In the present studies, we examined the immunolocalization of AQP1-5 in salivary glands of rat to clarify the potential roles of these for fluid secretion. Immunohistochemistry using cryosections of rat submandibular glands revealed that AQP1 was located in the capillary endothelia between secretory gland cells. Secretory gland cells and ductal cells were not labeled with anti-AQP1, AQP2 and AQP3 were not present in either salivary gland cells, intercalated ductal cells or striated ducts. AQP4 was localized in the basolateral plasma membrane domains of the intercalated ductal cells in rat submandibular glands whereas either secretory gland cells or striated ducts were not labeled. AQP5 was abundant in the apical domains of the secretory gland cells as well as of the secretory canaliculi and intercalated ductal cells, consistent with RT-PCR analyses as well as previous data (Nielsen et al., 1997). Importantly, AQP5 labeling was associated with the apical part of the secretory gland cells, raising the possibility for trafficking of AQP5 from intracellular vesicles to the apical plasma membranes following neuronal or hormonal stimulation. In parotid and sublingual glands, the immunolabeling pattern of AQPs was identical with that seen in submandibular glands, while the AQP5 immunolabeling was sparse in the sublingual glands which is mainly composed of mucinous glands. In conclusion, the basolateral localization of AQP4 in the intercalated ductal cells and presence of AQP5 in the apical plasma membrane of secretory acinar cells, canaliculi and intercalated ductal cells of submandibular gland suggest that both AQP4 and AQP5 may provide a critical pathway for osmotic water flow into the secreted fluid.

Lifestyle, Mental Health Status and Salivary Secretion Rates

The relations between salivary variables, lifestyle and mental health status were investigated for 61 healthy female university students. The salivary secretion rates were significantly higher in the good lifestyle group compared with the poor lifestyle group. Among the 8 lifestyle items tested, “eating breakfast” and “mental stress” were significantly related to the salivary secretion rates. The present findings suggest that the acquisition of a good lifestyle is also very important from the viewpoint of the prevention of oral disease. A highly significant correlation (r=0.97; p<0.01) between the salivary cortisol levels and the cortisol secretion rates when controlled for the salivary secretion rates was also observed. This suggests that there is a high correlation between the intact salivary cortisol levels and the total cortisol quantity per unit time. Therefore, both these values can be used as a good index for the salivary cortisol determination.

Differential Expression and Cellular Localization of Na+-K+-ATPase Isoforms in Rat Salivary Gland / 대한해부학회지

It is the existence of a polarized distribution of ion transporters and channels which is thought to underlie the vectorial salt movement. The present study was performed to examine the expression and polarized distribution of Na+-K+-ATPase isoforms believed to be essential for salivary secretion in the rat salivary gland using immunohis-tochemistry. Na+-K+-ATPase alpha1 subunit immunoreactivity was prominent in the granular convoluted duct of the submandibular gland, and striated and excretory duct of three major salivary glands. The submandibular ganglion and postganglionic nerve fiber exhibited moderate immunoreactivity, whereas the intercalated duct and acinar cells of major salivary gland were weakly labeled. Na+-K+-ATPase beta1 subunit immunoreactivity was prominent in the granular convoluted duct of the submandibular gland, intercalated duct of the sublingual gland, acinar cells of the parotid gland, and striated and excretory ducts of major salivary gland. The submandibular ganglion, intercalated duct of the submandibular gland, and acinar cells of the sublingual gland exhibited moderate immunoreactivity, whereas acinar cells of the submandibular gland and intercalated duct of the parotid gland were weakly labeled. In these segments, alpha1 and beta1 immunoreactivity was expressed at the basolateral pole, and no apical expression was detected. These results suggest that major salivary glands are comprised of at least two structurally unique Na+-K+-ATPase isoforms, which are participated in primary saliva formation and transport.