Tongue Cancer 환자에서 PET/CT 검사 시 Open Mouth 촬영법의 유용성 평가

김재환,윤종준,정지욱,김정욱,황주원,지혜인,Kim, Jae Hwan,Yun, Jong Jun,Jung, Ji Wook,Kim, Jung Wook,Hwang, Ju Won,Ji, Hye In 대한핵의학기술학회 2016 핵의학 기술 Vol.20 No.2

Tongue cancer는 혀에 생기는 악성종양으로 전체 암의 1.8%, oral cancer의 75%를 차지할 정도로 발생 빈도가 높은 것으로 알려져 있으며 초기 진단, 전이유무, 병기설정 등을 위해 PET/CT 검사를 실시하고 있다. Tongue cancer 환자의 PET/CT 검사 시 close mouth 상태로 Torso를 촬영하고 있으며 그에 따른 겹침이나 인공물의 영향으로 병소부위가 명확히 관찰되지 않는 경우가 발생되었다. 이에 open mouth로 PET/CT 검사 시 발생되는 변화와 그에 따른 유용성을 알아 보고자 한다. 20명의 환자(남 15명, 여 5명)를 대상으로 시행하였으며 먼저 close mouth 상태로 Torso 촬영 후 open mouth 상태로 1bed 추가 촬영하였다. Tumor(T), Normal Tongue(NT), Lymph Node(LN)에 관심영역을 설정하여 표준화섭취계수(standardized uptake value, SUV) $SUV_{mean}$, $SUV_{max}$를 측정하여 Background(Carotid artery) SUV를 빼주었다. Tumor size 변화를 측정하였으며 육안적 영상 해상도 평가는 blind test를 진행하였다. 비모수검정(wilcoxon signed rank test)을 통해 통계 분석하였다. Tumor에서 SUV는 open mouth 검사 시 증가하는 변화를 보였으며, normal tongue과 lymph node에서는 소폭의 변화가 있었으나 유의한 차이는 없었다. tumor size 변화와 blind test를 통해 전체적으로 비슷하거나 높은 영상 해상도를 보여주는 것을 확인할 수 있었다. Open mouth PET/CT 검사가 close mouth시 발생하는 문제점에 대한 완벽한 대안법이 될 수는 없지만 open mouth를 통해 구강 내 다른 구조물과의 겹침이나 tumor의 경계면을 조금 더 명확하게 관찰할 수 있을 것으로 사료된다. Purpose Tongue cancer is 1.8% of all cancer tumors occur in the tongue, it is known that the high incidence enough to account for 75% of oral cancer conducted a PET / CT examination for early diagnosis, metastasis, staging, etc. and. Tongue when PET / CT scan of a cancer patient and a Torso taken to close mouth lesions if the condition was caused due to the overlapping or corresponding artifacts are not clearly observed. The purpose of this study is to evaluate the changes that occur during PET / CT scan with open mouth and its usefulness under. Materials and Methods From June 2015 to March 2016 complained of herein by May 21 had received a diagnosis of tongue cancer underwent PET / CT scan patients were treated with a target (16 males, 5 female). The first was taken to close mouth Torso state, it was taken to add 1 bed open mouth condition. Tumor (T), measuring the Normal Tongue (NT), Lymph Node (LN) standard intake coefficient by setting a region of interest in the (standardized uptake value, SUV) SUVmean, the average value was measured SUVmax, drawn to each region of interest 3 times and Background (Carotid artery) was out of the SUV. In Chapter 3 of the slice to the tumor clearly visible by setting the region of interest to measure the change Tumor size was calculated average value. Gross Image resolution assessment were analyzed statistically through were divided into 1-5 points by the Radiation 7 people in 2, more than five years worked in specialized nuclear medicine compare to proceed with the blind test nonparametric test (wilcoxon signed rank test). (SPSS ver.18) Results $SUV_{mean}$ T's were in close mouth $5.01{\pm}2.70$ with open mouth $5.48{\pm}2.88$ (P<0.05), $SUV_{max}$ were respectively $8.78{\pm}5.55$ and $9.70{\pm}5.99$ (P<0.05). $SUV_{mean}$ in the NT were respectively $0.43{\pm}0.30$ and $0.34{\pm}0.24$ (P=0.20), $SUV_{max}$ was $0.56{\pm}0.34$ and $0.45{\pm}0.25$ (P=0.204). LN $SUV_{mean}$ were respectively $1.62{\pm}1.43$ and $1.69{\pm}1.49$ (P=0.161), $SUV_{mean}$ was $2.09{\pm}1.88$ and $1.99{\pm}1.74$ (P=0.131). Tumor size change is close mouth $4.96{\pm}4.66cm^2$ $5.33{\pm}4.64cm^2$ with 7.45% increase was (P<0.05), gross image resolution evaluation is $2.87{\pm}0.73$, $3.77{\pm}0.68$ with open mouth examinations 30.5% increase was (P<0.05). Conclusion Tumor SUV on the changes that had an increase in open mouth during inspection, the normal tongue and lymph node, but there was no significant difference in the change slightly. It is also one open mouth PET / CT scan will provide improved image to all patients with tongue cancer, but it could be confirmed that similar overall through the blind test, or tumor size changes and showing a high resolution image. It can be the perfect alternative method for problems that occur when the close mouth Open mouth PET / CT scan, but is believed to be through the open mouth to observe the boundary of overlapping or tumor of the oral cavity other structures a little more clearly. Tongue cancer patients how to recommend that the shooting further open mouth PET / CT.

동의수세보원(東醫壽世保元) 경험방(經驗方)에 근거한 사상체질별 설진(舌診)의 문헌연구

이재철,김종열,유현희,김근호,Lee, Jae-Chul,Kim, Jong-Yeol,Ryu, Hyun-Hee,Kim, Keun-Ho 사상체질의학회 2010 사상체질의학회지 Vol.22 No.1

1. Objectives: This study was performed to research the relationship between Sasang Constitution and characteristics of tongue diagnosis based on Donguisusebowon's Experience prescriptions(經驗方). 2. Methods: We searched tongue diagnosis factors in Donguisusebowon and classified this. Based on Donguisusebowon's Experience prescriptions(經驗方), we find tongue diagnosis factors in 6 contemporary Oriental medicine prescription books. 3. Results: Most So-eumin has white thin tongue coating and clear redish tongue color. Yellow tongue coatings are found in symptoms for Yinjinho-tang(Yinchenhao-tang), Soseungki-tang(Xiaochengqi-tang), Daeseungki-tang(Dachengqi-tang). Shortened Tongue is found in So-eumin's experience prescription and So-yangin's treat histroy. It didn't shown that So-eumin's Semen Crotonis included 6 prescritions' factors of tongue diagnosis. So-yangin's white tongue coating is found in Hyungbangpaedok-san(Jingfangbaidu-san), Sipjo-tang(Shizao-tang), Sosiho-tang(Xiaocihu-tang), Shinki-hwan(Shenqi-wan). Most of other So-yangin's tongue coatings are Yellowish and tongue color is deep red. Tae-eumin have thin white tongue coating at the Mahuang-tang(Mahuang-tang). Red tongue color and drying tongue are found at Jowiseungki-tang(Tiaoweichengqi-tang)Daesiho-tang(Dacihu-tang)Saengmaek-san(Shengmai-san) 4. Conclusions: Following So-eumin's Experience prescriptions, So-eumin's tongue color is clear red and tongue coatings are thin white and greasy. Following So-yangin's Experience prescriptions, So-yangin's tongue color is deep red and tongue coatings are yellowish and scarce except Exterior cold disease. And So-yangin has specific symptom of irritability, oral sores. Tae-eumin's tongue has two sides of white thin tongue coatings and Red and drying tongue.

가시광선, 근적외선, 자외선에 의한 혀의 영상 특성 비교연구

이상석,남동현,노재혁,이충희 한국물리학회 2011 새물리 Vol.61 No.5

In this study, we developed a medical tongue diagnosis device using three wavelengths of light: visible, near infrared (940 nm) and ultraviolet (375 nm). The device is composed of a light source equipped with visible, near infrared, and ultraviolet light-emitting diodes (LEDs), a photography section using a hivision camera, and a control section to obtain three tongue images. The near-infrared tongue image for imaging vein blood below the tongue showed the feature of tongue vein blood. One of the ultraviolet tongue images exhibited three fluorescent colors: red, green, and blue. The moisture on the tongue's surface, the thickness of a coating on the tongue, and the degree of fluorescent color could be established by comparing several tongue images: a wet tongue, a coated tongue, and a bongur painted with water, mayonez, and fluorescence pen color. 혀의 영상을 촬영하기 위한 장치인 설진기를 3파장대 광원인 가시광선,근적외선, 자외선 발광다이오드(LED)를 이용하여 제작하였다. 설진기는가시광선, 근적외선, 자외선 LED를 사용한 광원부와 반도체 소자가장착된 하이비전 카메라인 촬상부 및 가시광선, 근적외선, 자외선 영상을얻기 위한 제어부로 구성되어 있다. 근적외선 촬영은 설하정맥 영역의분리에 유리하며 자외선 형광 촬영은 설태의 종류를 구분하는데활용하였다. 혀에 물, 마요네즈, 형광펜을 독립적으로 묻혀 촬영한설진영상들의 비교를 통해 근적외선 영상으로 습윤도의 정보 획득과자외선 영상을 통해 황 화합물이 주성분인 설태의 두께와 형광정도의구분이 가능하였다.

설진(舌診)의 진단적 의의에 대한 문헌고찰

신윤진,김윤범,남혜정,김규석,차재훈,Shin, Yoon-Jin,Kim, Yoon-Bum,Nam, Hye-Jeong,Kim, Keoo-Seok,Cha, Jae-Hoon 대한한방안이비인후피부과학회 2007 한방안이비인후피부과학회지 Vol.20 No.3

Tongue diagnosis is a profound and special part of the whole Oriental Medicine. We examined the method, the principle and the meaning of tongue diagnosis according to a literature cited, considered a meaning of tongue diagnosis. As a result, we come to a conclusion like that. 1. Tongue is related with internal organs by meridian system, especially has a direct connection with heart and spleen. 2. The heart, a master of internal organs, has its specific opening in the tongue. The spleen, source of nutrients for growth and development, has its specific body opening in the mouth. So tongue reflects states of internal organs, Qi, blood, the constructive energy and the defensive energy. 3. When doing tongue diagnosis, we must pay attention to the position and the order of inspection of the tongue. We must diagnose by referring to a ray of light, diet, season, age, physical constitution, habit and taste, can make a accurate diagnosis. 4. We can classify constitutions, distinguish syndromes, suppose prognosis, make a prescription by using tongue diagnosis. 5. Reddened tip of the tongue represents flaring-up of the heart fire, and it means psychologic stress. Dental identations on the tongue edges represents deficiency of Qi of the spleen, and it means physiologic fatigue. 6. Through observing humidity of fur of the tongue, we can guess psychologic stress and physiologic fatigue. Through observing thickness of fur of the tongue, we can guess function of spleen and stomach.

피에르 로빈 연속증의 치료로써 치조 보호 장치를 이용한 혀-하순 유착술

이장원,박병윤 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.4

Purpose: Pierre Robin sequence is a congenital malformation in which micrognathia causes glossoptosis and airway obstruction. If conservative treatment fails, surgical procedures such as tongue-lip adhesion can be performed. However, this procedure remains a subject of debate, with favorable results being countered by reports of complications. To overcome the above limitations, we revised the traditional method of tongue-lip adhesion using an alveolar protector. Methods: Between 1992 and 2011, a total of eight patients were identified with Pierre Robin sequence and were treated with tongue-lip adhesion. Two of these eight tongue-lip adhesion procedures were performed with an alveolar protector. The operative technique for tongue-lip adhesion was similar to that described in other published reports. The alveolar protector was inserted between the ventral surface of the tip of the tongue and the lower labial sulcus. Results: Tongue-lip adhesion failed in two patients because of wound dehiscence. The primary surgical success rate was 66.7%. In the two tongue-lip adhesion procedures performed with the alveolar protector, we observed no postoperative complications. Conclusion: Resistance to traction of the tongue can be encountered with nonunionized symphysis menti, causing loosening of the traction suture through the symphysis menti. This can lead to backward positioning of tongue, resulting in dehiscence of tongue lip adhesion. The alveolar protector is a good adjunct to tongue-lip adhesion because this method avoids postoperative loosening of the traction suture and wound dehiscence. It is a simple and effective auxiliary method that yields functional improvement.

Development of a Tongue Immobilization Device Using a 3D Printer for Intensity Modulated Radiation Therapy of Nasopharyngeal Cancer Patients

주상규,안용찬,김영비,박승규,최유미,나초희,홍채선,오동렬,권동렬,김철종,김동현 대한암학회 2021 Cancer Research and Treatment Vol.53 No.1

Purpose This study aimed to reduce radiation doses to the tongue, a patient-specific semi-customized tongue immobilization device (SCTID) was developed using a 3D printer for helical tomotherapy (HT) of nasopharyngeal cancer (NPCa). Dosimetric characteristics and setup stability of the SCTID were compared with those of a standard mouthpiece (SMP). Materials and Methods For displacement and robust immobilization of the tongue, the SCTID consists of four parts: upper and lower tooth stoppers, tongue guider, tongue-tip position guide bar, and connectors. With the SCTID and SMP, two sets of planning computed tomography and HT plans were obtained for 10 NPCa patients. Dosimetric and geometric characteristics were compared. Position reproducibility of the tongue with SCTID was evaluated by comparing with planned dose and adaptive accumulated dose of the tongue and base of the tongue based on daily setup mega-voltage computed tomography. Results Using the SCTID, the tongue was effectively displaced from the planning target volume compared to the SMP. The median mucosa of the tongue (M-tongue) dose was significantly reduced (20.7 Gy vs. 27.8 Gy). The volumes of the M-tongue receiving a dose of 15 Gy, 30 Gy, and 45 Gy and the volumes of the mucosa of oral cavity and oropharynx (M-OC/OP) receiving a dose of 45 Gy and 60 Gy were significantly lower than using the SMP. No significant differences was observed between the planned dose and the accu-mulated adaptive dose in any dosimetric characteristics of the tongue and base of tongue. Conclusion SCTID can not only reduce the dose to the M-tongue and M-OC/OP dramatically, when compared to SMP, but also provide excellent reproducibility and easy visual verification.

혀세정기구의 형태에 따른 인공설태제거효과에 관한 비교실험연구

조자원,신승철,서현석 대한구강보건학회 2003 大韓口腔保健學會誌 Vol.27 No.1

The author surveyed 80 patients who had tongue plaque through the oral examination and taking the clinical photograph as well as classifying the type of tongue plaque, and made the tongue-cleaning machine and tested by using the machine to investigate efficiency of tongue plaque removing by the type of tongue cleaner, its material, and application force. The following result were obtainde; 1. Most adults have O-type tongue plaque(76.25%), other habe I-type tongue plaque(11.25%), and T-type tongue plaque(10.00%). 2. The efficiency of tongue plaque removing increased as tongue cleaning force rise. 3. Removing efficiency of O-type and T-type tongue plaque was higher by using linear filament type tongue cleaner than other tongue cleaner. 4. Groove type and linear filament type tongue cleaner hed higher removing efficiency of I-type tongue plaque. 5. Proper type tongue cleaner is recommended to each patient for prevention and reduction fo oral malodor and efficient tongue plaque removing.

모국어의 심급들, 토대로서의 번역 - 유종호의 ‘토착어’와 백낙청의 ‘토속어’

유승환 상허학회 2016 상허학보 Vol.47 No.-

이 논문은 1960년대 후반 이후 이루어진 모국어의 재편을 위한 의식적인 실천 및 그와 관련하여 나타난 모국어를 호명하는 개념들의 발생 조건을 한국(남한) 사회가 접속하고 있는 문화권의 변화 및 그로 인한 번역 상황의 변화라는 관점에서 검토하려고 한다. 1960년대는 모국어에 익숙한 소위 ‘한글 세대’에 의해 한국어에 기초한 새로운 감수성이 나타난 시기였다는 것은 우리에게 익숙한 문학사적 평가이다. 그러나 이러한 평가는 모국어 문학어의 선험적인 존재를 자명한 것으로 이해하고 있다는 점에서 일종의 신화이다. 모국어라는 개념은 다른 외국어로의 번역을 염두에 둘 때에만 상상될 수 있는 유동적 개념이며, 또한 끊임없이 완성을 향한 도정에 있는 미완태로서만 상상되는 개념이기도 하다. 따라서 모국어 문학어 또한 끊임없이 상상되고, 창안되고, 재편되는 과정에서 형성된다. 이 논문은 ‘토착어’, ‘토속어’와 같은 모국어 문학어의 존재 및 그 재편의 방향성을 동시에 지시함으로써 모국어 문학어의 심급을 지시하는 개념들의 발생과 분화가 해방 이후 변화된 번역 상황에 대한 인식과 그에 대한 대응 전략에 기초하고 있다는 점을 유종호와 백낙청의 비평을 통해 확인하려 한다. ‘토착어론’을 중심으로 1950년대 후반부터 시작된 모국어에 대한 유종호 비평의 궤적은 모국어 개념이 재확립되는 과정을 보여준다. 토착어에 대한 유종호의 비평은 초기의 양가적 입장에서, 토착어가 한자어보다 효과적인 사유의 언어가 될 수 있다는 입장으로 돌아선다. 이러한 선회의 배후에는 번역의 원어가 일본어(한자어)에서 영어 등의 서구어로 교체되어 상상되는 상황, 즉 문화권의 이동에 따른 번역 상황의 변화에 대한 인식이 놓여 있다. 이 점에서 유종호의 토착어론은 번역 상황의 변화가 모국어의 재인식 및 재편을 위한 중요한 조건이었다는 점을 드러낸다. 한편 ‘토속어’에 대한 백낙청의 사유는 변화된 번역 상황에 대한 대응 전략의 차이가 모국어 문학어의 재편을 위한 모국어의 심급들을 지시하는 용어의 분화에 중요한 요인이 될 수 있음을 보여준다. 일본어-한자어의 매개를 거치지 않고, 일종의 ‘보편어’로서의 서구어 원어에 직접 소급하려는 새로운 번역의 감각은 보편어와 민족어로서의 모국어 사이의 번역 가능성에 대한 새로운 전망을 창출했으며, 서구과학의 보편어와의 관계에서 모국어를 통한 번역 가능성 혹은 불가능성을 검토하는 것은 근대한국사회와 그 문학의 성격을 가늠하는 중요한 방식이었다. 백낙청은 이러한 작업을 가장 성실히 수행한 비평가였으며, 동시에 ‘토속어’는, 보편어로의 환원 (불)가능성을 지닌 채 각각의 원어에 대응하는 대상의 실재성을 보증하는 장치로서 이러한 작업에 있어 본질적인 중요성을 지닌 개념으로 자리매김된다. 이처럼 모국어의 심급들, 모국어 문학어의 존재와 가능성을 지시하는 개념들은 해방 이후 장기적으로 이루어진 번역 상황의 변화에 대한 인식에 기초하여 발생하고 또한 동일한 상황에 대한 대응 전략의 차이에 의해 분화된다. 모국어에 대한 유종호와 백낙청의 비평은 실제로 1960년대 후반 이후 모국어와 모국어 문학어의 재편으로 이어진다. 이때 이러한 모국어 문학어의 재편은 방언, 속어, 은어, 고어 등 모국어의 특정 심급들에 대한 의식적 수집과 활용에 의해 이루어진다. 그러나 이러한 언어의 의식적인... This study aims to study conscious practices to reorganize mother tongue and occurence of notions to call mother tongue in the late 1960s. This study suggests that change of cultural area to which Korea was connecting and change of translation-situation was a major condition of this phenomenon. It is a familliar appraisal that new sensibilities based on Korean was formed in the late 1960s by ‘Hangul generation’ who were used to mother tongue. However, this appraisal is a kind of myth, because it supposes transcendental being of the mother tongue. A concept of ‘mother tongue’ could only be imagined in relation with translation to other languages. And it was always imagined as an incomplete and a fluid concept. Thus, literary language based on mother tongue was also formed in the process of imaging, creating, reorganizing language. This study pay attention to a few concepts such as Yu Jong-ho’s ‘aboriginal language’ and Paik Nak-chung’s ‘local language’ which implied the degrees of mother tongue in the late 1960s. These concepts suggested the being of ‘pure’ mother tongue and directions of reorganizing mother tongue at once. And the occurence and differentiation of these concepts were based on consciosness about altered translation-situation after the liberation and counterstrategy of this situation. Yu Jong-ho’s criticism on aboriginal language started in the late 1950s. The transition of his perspective about aboriginal language showed re-establishing the concept of mother tongue. He had ambivalent viewpoint on aboriginal language in the initial stages. However, he changed his mind hencefoward and suggested aboriginal language could be more effective language of the reason than Sino-Korean words. Awareness of translation-situation which changed because of change of cultural area to which Korea was connecting placed behind this transition. In other words, he could assert superiority of aboriginal language because he thought not Japanese but English as an orginal language in changed translation-situation. Yu Jong-ho’s criticism on aboriginal language showed that the altered translation-situation was an important condition of reorganizing of mother tongue. Paik Nak-chung’s criticism on local language showed counterstrategy against altered translation-situation was an important element of differentiation of the concepts which called degrees of mother tongue. New sense of translation which discarded mediation of Japanese and Sino-Korean words and reach western Europe language as an original language created new perspective on possibilities of translation. Examination of possibilities of translation between mother tongue and universal language of modern science was an important way to estimate characteristics of modern Korean society and its literature. Paik accomplished these works sincerely. ‘Local language’ was magnified as an essential concept in this process, because it was imagined as a concept which has (im)possibility of translation to universal language and guarantees substantiality of equivalents to each original language. Thus, concepts which called degrees of mother tongue and literary language based on it altered translation-situation and were diffentiated by counterstrategy to this situation. Yu and Paik’s critism on mother tongue led to actual reorganzing of literary language based on mother tongue in the late 1960s. Intentional collection and utilization of specific sections in mother tongue such as dialect, slang, argot, archaic words were important methods to reorganize mother tongue in late 1960s. However these practices did not intend to restore existence which these languages instruct, but intended to reconsturuct equivalents to universal concepts which modern west European science suggested in new translation-situation. Thus, ‘archiving of languages’ is a useful concept to explain reorganization of literary language in the late 1960s.

설진 유효 영역 추출의 시스템적 접근 방법

김근호(Keun Ho Kim),도준형(Jun-Hyeong Do),유현희(Hyunhee Ryu),김종열(Jong Yeol Kim) 대한전자공학회 2008 電子工學會論文誌-SC (System and control) Vol.45 No.6

한의학에서 혀의 상태는 인체 내부의 생리적·병리적 변화와 같은 건강 상태를 진단하는 중요한 지표로 활용된다. 혀의 상태를 진단하는 방법(설진)은 편리할 뿐 아니라 비침습적이므로, 한의학에서 널리 활용되고 있다. 하지만, 설진은 광원이나 환자의 자세, 의사의 건강 조건과 같은 검사 환경에 따라 많은 영향을 받는다. 객관적이고 표준화된 진단을 위한 자동 설진 시스템을 개발하기 위하여 촬영된 얼굴 영상으로부터 혀를 영역분할하고 설태를 분류하는 것은 필수적이지만 혀와 입술, 입 근처의 피부색이 서로 유사하므로 쉽지 않은 일이다. 제안된 방법은 전처리 과정, 과 영역분할, 혀의 구조로부터 발생하는 음영 영역의 지역 최소값 위치 검색, 지역 최소값의 교정, 컬러의 차이를 최대로 하는 위치를 찾는 컬러 경계면 탐색, 혀의 기하적인 특성에 일치하는 경계면 선택, 경계면 평활화로 구성되어 있으며, 여기서 전처리 과정은 계산량의 감소를 위한 부 표본화, 히스토그램 평활화, 경계면 강화를 수행한다. 이러한 시스템적인 과정을 거치면, 영역분할된 혀를 획득할 수 있게 된다. 제안된 방법으로 분할된 영역은 효과적으로 혀가 아닌 영역을 제외해 낼 뿐 아니라 정확한 진단을 위해 중요한 정보를 제공함을 한의사의 진단 유효도 평가점수를 통해 확인할 수 있었다. 제안된 방법은 진단의 객관화와 표준화에 기여할 뿐만 아니라 u-Healthcare 시스템에도 활용 가능하다. In Oriental medicine, the status of a tongue is the important indicator to diagnose the condition of one's health like the physiological and the clinicopathological changes of internal organs in a body. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is affected by examination circumstances like a light source, patient’s posture, and doctor’s condition a lot. To develop an automatic tongue diagnosis system for an objective and standardized diagnosis, segmenting a tongue region from a facial image captured and classifying tongue coating are inevitable but difficult since the colors of a tongue, lips, and skin in a mouth are similar. The proposed method includes preprocessing, over-segmenting, detecting the edge with a local minimum over a shading area from the structure of a tongue, correcting local minima or detecting the edge with the greatest color difference, selecting one edge to correspond to a tongue shape, and smoothing edges, where preprocessing consists of down-sampling to reduce computation time, histogram equalization, and edge enhancement, which produces the region of a segmented tongue. Finally, the systematic procedure separated only a tongue region from a face image with a tongue, which was obtained from a digital tongue diagnosis system. Oriental medical doctors' evaluation for the results illustrated that the segmented region excluding a non-tongue region provides important information for the accurate diagnosis. The proposed method can be used for an objective and standardized diagnosis and for an u-Healthcare system.

Comparison of the Tongue-Palate Pressure Patterns According to the Tongue Pressure in Community-Dwelling Older Adults

Min-Ji Jo,Soo-Min Kim,Seong-Chan Park,Hye-Jin Park,Yun-Seon Lee,Tae-Woo Kim,Ji-Seon Hong,Eui-Yeon Lee,Sung-Hoon Kim,Sun-Young Han 한국치위생과학회 2023 치위생과학회지 Vol.23 No.4

Background: Oral frailty has garnered considerable interest following its identification as a risk factor for physical frailty. The Korean oral frailty diagnosis criteria have emphasized the need for extensive research on oral frailty diagnostic items and interventions. Our study performed an in-depth analysis of the tongue-palate pressure patterns in healthy community-dwelling older adults. Methods: Of the 217 older adults aged ≥60 years who visited a senior center in Wonju, 205 participants who completed tongue pressure measurement were included in the final analysis. Pressure changes over time were recorded by instructing the participants to press their tongue against the hard palate with for 7 seconds per cycle. The participants were divided into the normal and abnormal tongue pressure (NTP and ATP, respectively) groups based on whether they achieved the target tongue pressure at least once; tongue pressure patterns were compared between the groups. Furthermore, the average time taken to achieve the standard tongue pressure value was calculated for the participants in the NTP group and used to evaluate the decrease in tongue pressure in the ATP group. Results: Among the 205 participants, 40.5% had ATP. The tongue pressure graph revealed a gentle and consistent incline that was maintained even after achieving standard tongue pressure in the NTP group. The graph was more extreme in the ATP group, and the changes in the pressure type varied across individuals; the tongue pressure was only 48.4%, 40.7%, 31.9%, and 22.6% of the NTP in the participants in their 60s, 70s, 80s, and ≥90s, respectively (p<0.05). Conclusion: Tongue pressure weakness was observed in 40.5% of the healthy community-dwelling older adults. Furthermore, ATP graphs were observed in the patients with tongue pressure weakness. Thus, activities improving the oral function in community-dwelling older adults and systematic oral rehabilitation programs should be devised to promote normal swallowing.