The tongue features associated with type 2 diabetes mellitus.

Diabetes mellitus (DM) is a public problem closely associated with numerous oral complications, such as coated tongue, xerostomia, salivary dysfunction, etc. Tongue diagnosis plays an important role in clinical prognosis and treatment of diabetes in the traditional Chinese medicine (TCM). This study investigated discriminating tongue features to distinguish between type 2 DM and non-DM individuals through non-invasive TCM tongue diagnosis.The tongue features for 199 patients with type 2 DM, and 372 non-DM individuals, serving as control, are extracted by the automatic tongue diagnosis system (ATDS). A total of 9 tongue features, namely, tongue shape, tongue color, fur thickness, fur color, saliva, tongue fissure, ecchymosis, teeth mark, and red dot. The demography, laboratory, physical examination, and tongue manifestation data between 2 groups were compared.Patients with type 2 DM possessed significantly larger covering area of yellow fur (58.5% vs 22.5%, P < .001), thick fur (50.8% vs 29.2%, P < .001), and bluish tongue (P < .001) than those of the control group. Also, a significantly higher portion (72.7% vs 55.2%, P < .05) of patients with long-term diabetics having yellow fur color than the short-term counterparts was observed.The high prevalence of thick fur, yellow fur color, and bluish tongue in patient with type 2 DM revealed that TCM tongue diagnosis can serve as a preliminary screening procedure in the early detection of type 2 DM in light of its simple and non-invasive nature, followed by other more accurate testing process. To the best of our knowledge, this is the first attempt in applying non-invasive TCM tongue diagnosis to the discrimination of type 2 DM patients and non-DM individuals.

Características dermatoscópicas de las papilas fungiformes pigmentadas de la lengua / Dermoscopic Features of Pigmented Fungiform Papillae of the Tongue

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A Case of Subclinical Hypothyroidism with Lingual and Right Pretracheal Ectopic Thyroid.

Ectopic thyroid tissue is most commonly located in a single location, this being the lingual area. Presentation with two ectopic thyroid foci is quite unusual. A girl patient aged 7 years who presented with complaints of two masses in the right anterior neck and submandibular area is reported. Her growth pattern and development were normal. The masses were detected to be dual ectopic thyroid glands by ultrasonography, computed tomography and 99m-technetium pertechnetate thyroid scan. The patient also had subclinical hypothyroidism. She was treated with oral levothyroxine and the masses slightly decreased in size. The repeated thyroid function tests were within the normal limits. Thyroid function tests and imaging studies need to be conducted in all patients with anterior neck masses.

[Tongue coating, mouth odor, gustatory sense disorder - earlier and new treatment options by means of tongue scraper]. / Zungenbelag, Mundgeruch und Schmeckstörung - bisherige Behandlungsmethoden und neue Therapieoption durch mechanische Zungenreiniger.

The tongue is said to be the mirror of physical health. The tongue dorsum is most delicate regarding the sense of touch. Pathologic coating of the tongue accounts for paresthesia during chewing, swallowing, speaking, tasting, and also may result in mouth odor. Tongue coating can result from increased formation or decreased natural abrasion, and from xerostomia or dyschylia. In clinical otorhinolaryngology pathologic tongue coating often is idiopathic or present after surgery of the oral cavity or pharynx. Critical analysis of published studies reveals that effectivity and justification to administer xenobiotics or vitamins in that condition is doubtful. Recently, it has been shown that tongue fur was able to be reduced by an easy-to-handle mechanical tongue cleaner or tongue scraper. Due to its simple use, tongue scrapers could be a welcome supplement for the treatment of tongue fur, mouth odor, and in particular cases, to enhance gustatory sense. Preliminary results of an ongoing prospective trial showed that tongue scrapers can effectively be applied after surgery of the oral cavity or pharynx. After tonsillectomy, tongue fur seemed to be reduced and gustatory sense to be enhanced when tongue scrapers were applied during postoperative care. After confirming these promising results in further investigations, an inexpensive and simple option for the treatment of a large amount of patients in clinical otorhinolaryngology would exist.

Etiology, pathogenesis and treatment of habitual dislocations of the T.M. Joints [original work].

Definite treatment of any pathological condition, is based on the understanding of its correct pathogenesis and etiology. Without this basic understanding correct and lasting treatment is not possible. When there is no knowledge of exact pathogenesis and etiology, various theories and treatments are suggested by various workers. This is what exactly happened in the case of habitual dislocations of the T.M. Joints. This in term has happened because the dental surgeons and so called oral surgeons, never expanded their vision, beyond their restricted field of 20 deciduous teeth and 32 permanent teeth. Lack of understanding of basic physiological functions, of various tissues in the body and their effects on various systems as a whole was neglected. For this study four patients were selected from many, who could visit my clinic regularly and co-operate to follow all the instructions over a period of at least 5 years. The analysis of their symptoms and signs, had a different story to tell than what was described in the literature so far.

Familial occurrence of congenital hypothyroidism due to lingual thyroid gland.

Two sisters who presented with midline neck masses proved to be biochemically hypothyroid. Thyroid scintigraphy supplemented with perchlorate discharge testing showed lingual thyroid glands and ruled out the expected autosomal recessive organification defect. The related literature is reviewed.

Efficacy of a riboflavin supplement given at fortnightly intervals to pregnant and lactating women in rural Gambia.

Thirty-seven women living in two rural Gambian villages, who were either pregnant or lactating at the outset of the study, received a tablet containing 15 mg riboflavin, or a placebo, at fortnightly intervals for 10 weeks at a time of year when riboflavin status was deteriorating. Clinical assessments were carried out once a week, with particular attention to signs and symptoms of riboflavin deficiency, and blood samples were taken at the beginning of the study and after 4 and 10 weeks supplementation for the assessment of riboflavin status by the activation coefficient of erythrocyte glutathione reductase. The overall incidence of lingual papillary atrophy increased significantly during the course of the study, but the increase was significantly smaller in the supplemented than in the placebo group. More complaints of sore mouths were encountered in the placebo group. Biochemical evidence of deficiency was very marked at the outset, and showed some improvement after supplementation, but values within the normal range were not achieved. It is concluded that a riboflavin supplement given at spaced intervals can be clinically beneficial, despite failure to achieve normal biochemical indices. This may have practical implications for intervention programmes.

[Etiology and treatment of glossodynias]. / Ouelques idées sur l'étiologie et le traitement des glossodynies

This study only concerns classical glossodynia with few symptoms and not related to general, tumoral or local syndromes. Lingual pain is caused in the majority of cases by apraxic movements of the tongue. These movements, related to the anguish, can by a regressive process be related to the "searching" lingual movements of the child in psychological distress. The patient suffering from glossodynia (usually a woman) is enclosed in a viscious circle : anguish, apraxic movements, lingual pain, of which the beginning is often contemporary with a cancer in the area. Therapy should be addressed first of all at the distress, by looking very closely at the patient, by examining her very carefully, by absolutely gaining her confidence and by asserting the absence of cancer while admitting the reality of her disease. It should then be addressed to the lingual movements, by immobilization exercises giving rise to consciousness of movements up to then unconscious. Relaxation exercises can be combined. Failure of this therapy : frequent in men, in those who speak a lot (teachers), in hysterics "pithiatics", senile, and those persons whose intellectual evolution is slight. The author emphasizes the therapist's availability ; success in this treatment being related to what he can give of himself to these patients.