The purpose of this study was to investigate the clinical effect of oriental herbal medicine (baku-mon-doto) on xerestomia.
The subjects were 1 male and 15 female patiants with xerostomia visited at Jichi Medical School Hospital. The age ranged from 54 to 82 years old, with an average of 67 years. Fifteen cases were medically compromised patiants and they had been treated with some medicines.
We applied“baku-mon-doto” of oriental herbal medicine for one month. Thirteen patients (81%) have improved in subjective symptoms of xerestomia by this treatment. In eight patients (50%), the unstimulated whole saliva for 5 minutes was more than 0.5ml/5min. The side effect of the drug was not recognized.

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The efficacy of cevimeline hydrochloride hydrate for the treatment of dry mouth in patients with Sjögren's syndrome (SS) was evaluated. A total of 32 patients with SS consisted of 31 females and 1 male. The mean age of patients was 60.1 years. An increase tendency was significantly seen in quantity of saliva secretion until 48 weeks, and the cases observed whose saliva flow was increased at the time points of 84 weeks or 72 weeks of the administration. An improving tendency in patients' subjective symptoms was also observed during the long term follow-up period.

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Generally Sjögren's syndrome (SS) patients are above middle age, but juvenile patients are diagnosed as SS sometimes. It is thought that, dry mouths of juvenile SS patients are not serious. So, the comparison of clinical examinations between under 40 SS patients and above 40 SS patients were carried out. The clinical profiles of patients with SS were obtained from 136 patients who had visited our clinic, during the period from 1995 to 2002. The diagnosis of SS was based on the revised Japanese criteria for SS (1999). As a result, the group of under 40 SS patients showed relatively low positive rates by dry mouth examinations and/or dry eye examinations, however the group showed high positive rates of auto-antibodies in serology. In addition, unidentified fever was most seen as chief complaint of primary SS under 40 patients. So, we should doubt SS, even if the patients without dry mouth, when unidentified fever and parotid swelling are examined.

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Cevimeline hydrochloride, a remedy for treating xerostomia due to Sjögren's syndrome (referred to SS below), showed a superior effectiveness on this syndrome as compared with conventional remedies. However, some of the patients thus treated showed no or inadequate response. In the present study, therefore, possible background factors which may influence on the effect of this agent were examined.
One hundred patients so far diagnosed as SS in our department and treated with cevimeline hydrochloride for at least 12 months during the period from September 2001 to December 2003 were enrolled in this study. In these cases, possible background factors which may have influenced on the increase rates of salivary secretion, the amount of increase in saliva and the improvement rates of subjective symptoms were examined efficacy rate of after 12-month administration.
Both pre-administration gum test values and sequential salivary scintigraphy scores were found to have exerted influence on efficacy rate of the increase rates of the salivary secretion. And both pre-administration subjective symptom scores and sequential salivary scintigraphy scores were found to have exerted influence on efficacy rate of the amount of increase in saliva after 12-month administration. In addition, efficacy rate of the improvement rates of subjective symptoms seemed to have been influenced by the patient's age, presence or absence of collagen disease and pre-administration gum test values.

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Myelodysplastic syndrome (MDS) is a refractory myeloid disease that often transforms to leukemia. We encountered a 79-year-old female who presented with an oral symptom as a Prodromal sign. During treatment of refractory stomatitis, the patient developed fatigue and progressive anemia and pancytopenia, and was diagnosed as having MDS. The stomatitis subsided and recurred repeatedly until the start of blood transfusion, after which no recurrence was observed.

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Here we report a rare case of bullous pemphigoid initially occurred in the oral mucosa. An 85-year-old woman was referred to our hospital for erosions and ulcers of the oral mucosa and multiple skin lesions. She had the oral lesions for three months and the skin lesions developed after the occurrence of the oral lesions. She was diagnosed as bullous pemphigoid by immunofluorescence, immunoblotting, and ELISA. Steroid, nicotinamide, and tetracycline were systemically administered and the lesions responded well with complete healing in a couple of months.

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