Pathogenesis of many autoimmune diseases has been still unclear, and establishment of the radical therapy based on the pathogenesis has been coveted by a number of patients with autoimmunity. Sjögren's syndrome (SS) is well known to be one of systemic autoimmune diseases in the exocrine glands. Detailed cellular and molecular pathogenesis of SS also remains a mystery. In this review article, the history of SS mouse models and the significant findings were described and discussed according to the previous reports including our data. In addition, recent results focusing on T cell and macrophage were explained. Finally, a possible therapeutic strategy based on the results using immune checkpoint molecules was discussed. We have to overcome the challenge to help numerous patients suffering from various severe symptoms; even a journey of a thousand miles begins with a single step to solve a lot of problems in the intractable diseases.

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Purpose: The purpose of this research was to develop a novel method to quantitatively evaluate chewing features during daily meal events.
Methods: An occlusal tooth contact sensor with a bone conduction sound system was used as a chewing counter, and surface electromyography of the masseter muscle and a previously used chewing counter (bitescan) were also used to evaluate the validity of the novel chewing counter. The number of chewing cycles and other chewing features were recorded in 10 adult volunteers while eating lunch.
Results: The average number of chewing cycles was 541, the mean duration of chewing was 11.0 minutes, and the chewing speed was 51.3 cycles/minute.
Conclusion: The chewing features measured with the novel method exhibited good consistency with the other chewing counting methods.

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Objectives: Some dependent older adults have a lot of dry phlegm and debris leading to the presence of bacteria firmly adhered to the oral and pharyngeal mucosa. This must be removed completely and safely to maintain oral hygiene and general health. We developed a new oral care gel, Okuchi-Wo- Arau-Gel® (OG) that softens dry phlegm and debris allowing them to be removed easily and safely. The aim of this study was to evaluate the removability of simulated dry phlegm and debris in vitro using the OG.
Methods: In this experiment, standardized bovine thrombus (test soil) was used as simulated dried sputum or residue to compare the ability of OG and three commercial gels, Viva-Jellwet® (VJ), Refrecare® (RC), and Biotene OralBalance® gel (BT), to remove bovine thrombus. The test soil was covered with 0.5 mL of each gel, which was suctioned with a probe 1 min after (Experiment I) and 10 min after (Experiment II), spreading. The test soils were photographed with a digital camera and the digital images were analyzed in Photoshop. The pixel numbers of test soil were compared after suctioning, and a decrease in pixels was calculated as the removal value. Additional apparent viscosity and pH experiments were performed to confirm the physical properties of the research gels.
Results and discussion: The OG and VJ had a significantly higher removal value than the other gels in Experiment I. The OG had a significantly higher removal value than the other gels in Experiment II. The apparent viscosity of the OG and VJ was significantly lower than that of RC and BT. The pH of the gel ranged from 6.19 to 7.15. The OG and VJ retained more water than RC and BT and penetrated the test soils more easily. Additionally, the OG component had a higher removal rate in the test soils than VJ because it contained a surfactant.
Conclusions: In this in vitro study, the OG exhibited a greater ability to remove test soils compared with VJ, RC, and BT. The results indicate that the OG and VJ might be more effective than other gels at removing dry phlegm and debris from the oral and pharyngeal mucosa, whereas RC and BT have better anti-evaporation properties. We think that selecting gels by purpose is one way to improve the quality of oral care.

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Basal cell adenoma (BCA) is a rare type of benign salivary grand tumor. It frequently occurs in the parotid grand but rarely in the minor salivary grands. We report a rare case of BCA of the buccal mucosa. A 81-year-old man presented to our department with a mass of his left side of buccal mucosa. Intraoral examination revealed an elastic-hard, mobile, well-circumscribed submucosal mass covered with normal mucosa, measuring about 15mm in diameter. Ultrasonography showed welldefined hypoechoic area and slight blood flow. Clinical diagnosis was benign buccal tumor. The tumor excision was performed under intravenous sedation. Since the tumor had distinct capsule and no adhesion with surrounding tissue, it was easily resected. Histopathological examination revealed that the tumor was encapsulated by thin fibrous connective tissue. Some tumor nests presented with double layered tubular structure composed of inner luminal cells and outer basaloid and myoepithelial cells. Immunohistochemical examination revealed that the basaloid and the myoepithelial cells were positive for p63 and the luminal cells and the stromal cells were positive for S-100. Ki-67 labeling index was less than 1%. Histopathological diagnosis was BCA. Postoperative course is uneventful. Tumor recurrence has not been observed over 3 years.

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