Features Of Tongue Research Articles

Hairy Tongue: Differential Diagnosis by Use of Widefield Optical Fluorescence.

Hairy tongue is a benign pathology, characterized clinically by hyperkeratinized plaques on the dorsal surface of the tongue, hairlike, whose coloration ranges from unpigment, whitish, yellowish, green, brown to black. Diagnosis is clinical, and, in cases of whitish plaques, it may be difficult to differentiate between oral hairy leukoplakia, potentially malignant leukoplakia or squamous cell carcinoma. Thus, widefield optical fluorescence complementary examination may allow a better visualization of the local hairlike pattern of hyperkeratinization, typical of the hairy tongue, facilitating the diagnosis. In this work, a 57-year-old man was referred to the Dental Specialties Department of the Divinópolis Health Department (MG, Brazil) by a general dental practitioner, aiming a differential diagnosis of possible malignant lesion on the dorsal tongue surface. The complementary examination by wide-field optical fluorescence was performed. For this, it was employed a device with high-power light-emitting diode emitting light centered at a wavelength of (400±10) nm and maximum irradiance of (0.040±0.008) W/cm2 was used for fluorescence visualization. Fluorescence images showed projections of hairlike appearance in tongue dorsal surface with no aspects of malignancy. Hairlike appearance is the principal feature of hairy tongue. In this way, the final diagnosis was established. In conclusion, in this case, the use of widefield optical fluorescence in oral diagnostic routine provided a differential diagnosis, with no need of an incisional biopsy.

Analysis and recognition of characteristics of digitized tongue pictures and tongue coating texture based on fractal theory in traditional Chinese medicine.

Simple fractal dimensions have been proposed for use in the analysis of the characteristics of digitized tongue pictures and tongue coating texture, which could further the establishment of objectified classification criteria under the conditions of expanding sample size. However, detailed descriptions on simple fractal dimensions have been limited. Therefore, BP (back propagation) neural network model classifiers could be designed by further calculation of the multiple fractal spectrum characteristics of digitized tongue pictures in order to classify and recognize the thin/thick or greasy characteristics of tongue coating.The fractal dimensions of sample data of 587 digitized tongue pictures were collected in a standard environment. A statistical analysis was conducted on the calculation results of the sample data, and the sensitivity of the fractal dimensions to the thin/thick and greasy characteristics of digitized tongue pictures was observed. As the overlap region resulted from a range of values of a single parameter, another eight characteristic parameters of the multiple fractal spectra of the digitized tongue pictures were further proposed as the elements in the input layer of the three-layers BP neural network. Automatic recognition classifiers were designed and trained for the characteristics of digitized tongue pictures and tongue coating textures.The simple fractal dimension was sensitive to the thin/thick and greasy characteristics of digitized tongue pictures and could better judge the characteristics of the thickness of the tongue coating. A classifier with characteristic parameters of multiple fractal spectra as the input vectors identified by the BP neural network models could effectively increase the accuracy rate judged by the characteristics of the tongue coating texture.

Tongue inspection

Background. Tongue inspection (TI) is important for diagnosis and prognosis in traditional Chinese medicine (TCM). Tongue evalua­tion models vary among countries; however, no systematic protocol is in place. Objective. To propose a systematic protocol for TI to be used in neurology. Method. 1) A review of the books in English, Portuguese, and Spanish, and of papers in English, Portuguese, Span­ish, and French retrieved from the databases Pubmed, Lilacs, and Cochrane Library using the following descriptors: tongue, diagnosis, prognosis, traditional Chinese medicine; 2) Selection of the major tongue characteristics; search for a tongue examination protocol, and search for descriptions of features related to prognostic assessment. Results. In total, 26 articles were selected; however, none of them provided information pertaining to the object of the present study, or the information was inaccurate and vague. The same occurred with the Western medicine books, as none of them outlined a protocol. A TCM-based TI protocol was prepared, comprising four levels of severity and complexity. Conclusion: A systematic TI protocol was created for use in integrative medicine (Western and Chinese medi­cine), eliminating the divergent points and simplifying the items to be assessed during tongue inspection.

Analysis and recognition of characteristics of digitized tongue pictures and tongue coating texture based on fractal theory in traditional Chinese medicine

Simple fractal dimensions have been proposed for use in the analysis of the characteristics of digitized tongue pictures and tongue coating texture, which could further the establishment of objectified classification criteria under the conditions of expanding sample size. However, detailed descriptions on simple fractal dimensions have been limited. Therefore, BP (back propagation) neural network model classifiers could be designed by further calculation of the multiple fractal spectrum characteristics of digitized tongue pictures in order to classify and recognize the thin/thick or greasy characteristics of tongue coating. The fractal dimensions of sample data of 587 digitized tongue pictures were collected in a standard environment. A statistical analysis was conducted on the calculation results of the sample data, and the sensitivity of the fractal dimensions to the thin/thick and greasy characteristics of digitized tongue pictures was observed. As the overlap region resulted from a range of values of a single parameter, another 8 characteristic parameters of the multiple fractal spectra of the digitized tongue pictures were further proposed as the elements in the input layer of the three-layers BP neural network. Automatic recognition classifiers were designed and trained for the characteristics of digitized tongue pictures and tongue coating textures. The simple fractal dimension was sensitive to the thin/thick and greasy characteristics of digitized tongue pictures and could better judge the characteristics of the thickness of the tongue coating. A classifier with characteristic parameters of multiple fractal spectra as the input vectors identified by the BP neural network models could effectively increase the accuracy rate judged by the characteristics of the tongue coating texture.

Tonguenet: Accurate Localization and Segmentation for Tongue Images Using Deep Neural Networks

Tongue diagnosis is an important way of monitoring human health status in traditional Chinese medicine. As a key step of achieving automatic tongue diagnosis, the major challenges for robust and accurate segmentation and identification of tongue body in tongue images lay in the large variations of tongue appearance, e.g., tongue texture and tongue coating, caused by different diseases for different patients. To cope with these challenges, we propose a novel end-to-end model for multi-task learning of tongue localization and segmentation, named TongueNet, in which pixel-level prior information is utilized for supervised training of deep convolutional neural network. Firstly, we introduce a feature pyramid network based on the designed context-aware residual blocks for the extraction of multi-scale tongue features. Then, the region of interests (ROIs) of tongue candidates are located in advance from the extracted feature maps. Finally, finer localization and segmentation of tongue body are conducted based on the feature maps of ROIs. Quantitative and qualitative comparisons on real-world datasets show that the proposed TongueNet achieves state-of-the-art performance for the segmentation of tongue body in terms of both robustness and accuracy.

Trends of Tongue Features in Functional Dyspepsia Patients

Trends of Tongue Features in Functional Dyspepsia Patients

Investigation of Clinical Features of Geographic Tongue: Unveiling Its Relationship with Oral Psoriasis

Introduction: Few studies have examined the clinical features of geographic tongue (GT), an inflammatory lesion, which renders the diagnosis and investigation of oral psoriasis difficult.

Ultrastructure of the tongue and histochemical features of the lingual salivary glands in buzzards

The macroscopic characteristics of the tongues of 8 long-legged buzzards are described and scanning electron microscopy was used to examine the epithelial tissue of the tongue?s surface. Crossman?s modified triple staining method and hematoxylin and eosin dye were used to determine the locations and general histological features of the lingual salivary glands. The nature of the glandular secretions was examined by staining with PAS, AB pH 1.0, AB pH 2.5, and PAS-AB pH 1.0 and pH 2.5, and diastase enzyme digestion. PAS staining and weak, moderate, and strong methylation procedures as well as sialidase and hyaluronidase applications were performed. We report the finding of focal accumulations of the anterior lingual salivary glands at the tongue?s base with numerous duct openings in this area. This finding, in conjunction with the absence of taste papillae in the tongue epithelium, suggests that the role of the tongue in buzzards is to mix food with saliva and to move the food bolus rapidly to the back of the oral cavity. The acidic secretions of the lingual salivary glands not only have antimicrobial effects but also facilitate the swallowing process and may influence the digestive process in the distal parts of the alimentary tract.

Association of Cold-Heat Patterns with Tongue Features, Body Composition, Anthropometric Indices, and Blood Parameters in Tae-Eum Type.

Introduction The purpose of this study was to elucidate the relationship between cold-heat patterns and body composition, anthropometric indices, blood parameters, and tongue features in Tae-Eum type subjects. We also sought to determine whether significant indicators could be used as risk factors for predicting cold-heat patterns in a clinic. MethodsThis prospective, case-control pilot study was conducted at a single center. The subjects were males and females aged 19 years or older who had been analyzed as the Tae-Eum type. After screening, subject allocation was performed. The body composition, 11 anthropometric indices, blood parameters, and tongue features of the subjects were measured by well-trained practitioners. An independent t-test was conducted to compare the cold- and heat-pattern groups. Binary logistic regression was performed to determine significant differences between the two groups after adjusting for age, sex, and systolic blood pressure, with a focus on identifying significant indicators. ResultsEighty-nine participants were recruited, 39 of whom were excluded from the analysis. Ultimately, 20 cold-pattern and 30 heat-pattern subjects were included in the final analysis. We found that alanine aminotransferase and all anthropometric indices, except for neck and forehead circumference, were significant predictive factors in both groups according to the binary regression analysis. Additionally, the tongue body color in the cold-pattern group was significantly paler than that in the heat-pattern group. ConclusionsThis study found that cold and heat patterns were significantly associated with body composition, anthropometric indices, blood parameters, and tongue features. We suggest that these factors could thus be used as objective indicators and predictors of cold-heat patterns. Our findings provide fundamental but also applicable data that will be useful for diagnosing and monitoring cold-heat patterns in Tae-Eum type patients.

Automated tongue diagnosis on the smartphone and its applications

Tongue features are important objective basis for clinical diagnosis and treatment in both western medicine and Chinese medicine. The need for continuous monitoring of health conditions inspires us to develop an automatic tongue diagnosis system based on built-in sensors of smartphones. However, tongue images taken by smartphone are quite different in color due to various lighting conditions, and it consequently affects the diagnosis especially when we use the appearance of tongue fur to infer health conditions. In this paper, we captured paired tongue images with and without flash, and the color difference between the paired images is used to estimate the lighting condition based on the Support Vector Machine (SVM). The color correction matrices for three kinds of common lights (i.e., fluorescent, halogen and incandescent) are pre-trained by using a ColorChecker-based method, and the corresponding pre-trained matrix for the estimated lighting is then applied to eliminate the effect of color distortion. We further use tongue fur detection as an example to discuss the effect of different model parameters and ColorCheckers for training the tongue color correction matrix under different lighting conditions. Finally, in order to demonstrate the potential use of our proposed system, we recruited 246 patients over a period of 2.5 years from a local hospital in Taiwan and examined the correlations between the captured tongue features and alanine aminotransferase (ALT)/aspartate aminotransferase (AST), which are important bio-markers for liver diseases. We found that some tongue features have strong correlation with AST or ALT, which suggests the possible use of these tongue features captured on a smartphone to provide an early warning of liver diseases.

In Utero Glossoptosis in Fetuses With Robin Sequence: Measurements From Prenatal MRI.

Glossoptosis causes airway obstruction in patients with Robin sequence (RS), but little is known about the in-utero tongue. The purpose of this study was to assess shape and position of the fetal tongue on prenatal magnetic resonance imaging (MRI) to determine if this is predictive of postnatal RS. Retrospective case-control study including fetuses with prenatal MRIs performed from 2002 to 2017. Inclusion criteria were (1) prenatal MRI of adequate quality, (2) live born and evaluated postnatally for craniofacial findings. Subjects were divided into groups based on postnatal findings: (1) RS, (2) micrognathia without RS, and (3) a gestational-age-matched control group with normal craniofacial morphology. Outcome variables were based on the prenatal MRI and included fetal tongue height, length, and width, tongue shape index (TSI, ratio of height to length), and observation of tongue touching the posterior pharyngeal wall. A total of 116 subjects with mean gestational age at MRI of 25.6 ± 5.1 weeks were included: RS, n = 27 (23%); micrognathia, n = 35 (30%); control, n = 54 (47%). Tongue length was significantly shorter ( P = .009) and TSI was significantly larger in the RS group ( P < .0001). The tongue touched the posterior pharyngeal wall in 5 (19%) of the RS group and in no subjects in the other groups ( P < .0001). In utero tongue shape and position were significantly different in fetuses with postnatal RS compared to those with isolated micrognathia and controls. Prenatal MRI tongue characteristics may be predictors for postnatal RS.

Histomorphological features of the tongue of the Eurasian teal (Anas crecca).

This study presents the histomorphological features of tongue in Eurasian teal (Anas crecca); the smallest extant dabbling duck. Heads of four adult males and four adult females were used in this study. The results illustrate a tongue with three different parts; the apex with a lingual nail in ventral surface, the body with a lingual prominence in caudal part and some large and small conical papillae in lateral sides and the root, that was covered with many conical papillae in different sizes. Histological results revealed two types of keratinized and non-keratinized epithelium covering parts of the tongue. The lingual salivary glands were observed in the lamina propria of the body and root of the tongue showed strongly periodic acid-Schiff (PAS)-positive reaction. The yellow adipose tissue was located under the lamina propria on the body and root of the tongue. The filiform papillae between the conical papillae of the body were arranged densely. The sensory organs, which contain sensory receptors (Grandry and Herbst corpuscles), were located in the lamina propria of the body of the tongue. In conclusion, the anatomical and histological structure of the Eurasian teal' tongue was generally similar to its family members such as domestic goose and duck but showed some differences that may be adoptions to the bird's habitat and mode of feeding.

묘사분석과 전자코 및 전자혀를 이용한 시판 조미료의 관능적 특성

묘사분석과 전자코 및 전자혀를 이용한 시판 조미료의 관능적 특성

Objective research on tongue manifestation of patients with eczema.

Tongue observation often depends on subjective judgment, it is necessary to establish an objective and quantifiable standard for tongue observation. To discuss the features of tongue manifestation of patients who suffered from eczema with different types and to reveal the clinical significance of the tongue images. Two hundred patients with eczema were recruited and divided into three groups according to the diagnostic criteria. Acute group had 47 patients, subacute group had 82 patients, and chronic group had 71 patients. The computerized tongue image digital analysis device was used to detect tongue parameters. The L*a*b* color model was applied to classify tongue parameters quantitatively. For parameters such as tongue color, tongue shape, color of tongue coating, and thickness or thinness of tongue coating, there was a significant difference among acute group, subacute group and chronic group (P< 0.05). For Lab values of both tongue and tongue coating, there was statistical significance among the above types of eczema (P< 0.05). Tongue images can reflect some features of eczema, and different types of eczema may be related to the changes of tongue images. The computerized tongue image digital analysis device can reflect the tongue characteristics of patients with eczema objectively.

Characteristics of tongue and pharyngeal pressure in patients with neuromuscular diseases.

BackgroundTongue and pharyngeal pressure is an essential factor associated with the swallowing function; however, little is known about the difference in tongue and pharyngeal pressure between neuromuscular diseases. This study aimed to characterize tongue and pharyngeal pressure in myotonic dystrophy type 1 (DM1), Duchenne muscular dystrophy (DMD), and amyotrophic lateral sclerosis (ALS) patients.MethodsThis study recruited 17 DMD patients, 32 DM1 patients, and 26 ALS patients. They underwent separate measurements of tongue and pharyngeal pressure under videofluoroscopy, swallowing 5 mL of barium water. We measured the largest change in pharyngeal pressure in the hypopharynx and the upper esophageal sphincter (UES) over several swallows.ResultsThe mean tongue pressure (TP) was greatest in the DMD group than in the other groups (p<0.01). There was a significant difference in pressure changes in the hypopharynx and UES between the DM1 group and other groups (p<0.01). Significant correlations were observed between pressure change in the UES and the patient’s age in the DMD group (R=–0.500, p=0.045) and between pressure change in the hypopharynx and TP in the DM1 group (R=0.421, p=0.016). There was a significant correlation between pressure change in the hypopharynx and disease severity in the ALS group (R=0.435, p=0.030).ConclusionPatients with DMD, DM1, and ALS have weakness in the muscles involved in swallowing; however, the results of this study suggested that each disorder has a distinctive profile of impairment in the swallowing function.

Lingual structural pattern of juvenile Chameleon, Chameleo chameleon

It is belong to the order Squamata, family, Chamaeleonidae. They have characteristic features of tongue protrusion during capturing prey attracts many research works and assay its velocity during protrusion. Yet little studies touched the anatomical and histological feature of the juvenile tongue and especially the middle tongue region involved in the tongue elongation, the present study aimed to focus on the histological structure of the mid-tongue and clarify its role in projection of the tongue as well as the glandular structure, keratinization of lingual epithelium and proliferation capacity of the fore-tongue region in relation with their feeding habits during the juvenile age. Juvenile Chameleo chameleon are collected from Abu Rawash, north of Giza Governorate, Egypt during summer 2015. Three juvenile developmental stages are used in the present study and categorized according to the gross morphological criteria of head, abdomen and limb lengths. The tongue and hyoid apparatus were removed and photographed. Histological, immunohistochemistry of cytokeratin and stem cell factor and scanning electronic microscopic investigations were carried out on the fore-tongue region, meanwhile only histological studies were done for the median tongue region. Morphometric assessments of number and length of lingual papillae and grades of cytokeratin and stem cell expression were done. Histologically, the dorsal lingual mucosa of the fore-tongue possessed different pattern of lingual papillae including finger-like, club, cubical, biforked and multi-branched papillae. The finger-like papillae are more abundant compared to the other types. The lamina propria of anterior median tongue pad are more glandular and exhibited abundant distribution of PAS-positive tubular glands and moderate alcian blue staining affinity of both alveolar and branched alveolar glands. There is no detected keratinization of the lingual epithelium. Stem cell factor appeared denser on the lingual mucosa and cell boundaries of glandular tissues. The mid-tongue region possessed a central cartilaginous core outlined by double layers of connective tissue coat and longitudinal and circular muscle fibers which give the power of protrusion of tongue. It is the first time to record the presence of cartilaginous elements in the mid-tongue region of chameleon. Finally the authors concluded that the juvenile stages of common chameleon exhibited striking cartilaginous inner compartment of the med-tongue and glandular fore-tongue adapted for capturing prey coincides with high proliferated activities and presence of different kinds of non-keratinized lingual papillae.

Investigation of the clinical features of geographic tongue: unveiling its relationship with oral psoriasis.

Few studies have examined the clinical features of geographic tongue (GT), an inflammatory lesion, making diagnosis and the investigation of oral psoriasis difficult. To investigate the clinical features of GT to facilitate its identification and understand its relationship with psoriasis. A total of 96 participants diagnosed with GT underwent stomatological and dermatological examinations. The parameters assessed were burning sensation; number, classification, and location of lesions; loss of papillae; severity of GT lesions; and association with fissured tongue (FT). Psoriatic patients (PS) and those without psoriasis (NPS) were compared. Burning sensation was reported by 45 (47%) patients, 67 (70%) patients showed active GT, 68 (71%) presented with typical lesions, and 59 (61%) exhibited moderate lesions. GT was associated with FT in 75% of the cases and exhibited a diffused pattern associated with severe lesions. It was also more frequent in the PS group. The comparative analysis between the PS and NPS groups showed significant differences between the groups with regard to gender, presence of burning sensation, and GT severity. GT is a symptomatic lesion with a thick halo. In contrast, psoriatic patients are frequently asymptomatic and exhibit severe lesions with greater loss of papillae that are associated with severe FT. The present study is the first to demonstrate clinical differences in the GT of patients with and without psoriasis, suggesting that some GT cases may represent true oral psoriasis and some cases may represent only GT.

Differences in the Tongue Features of Primary Dysmenorrhea Patients and Controls over a Normal Menstrual Cycle.

Background The aims of this study were to investigate the relationships between tongue features and the existence of menstrual pain and to provide basic information regarding the changes in tongue features during a menstrual cycle. Methods This study was conducted at the Kyung Hee University Medical Center. Forty-eight eligible participants aged 20 to 29 years were enrolled and assigned to two groups according to their visual analogue scale (VAS) scores. Group A included 24 females suffering from primary dysmenorrhea (PD) caused by qi stagnation and blood stasis syndrome with VAS ≥ 4. In contrast, Group B included 24 females with few premenstrual symptoms and VAS < 4. All participants completed four visits (menses-follicular-luteal-menses phases), and the tongue images were taken by using a computerized tongue image analysis system (CTIS). Results The results revealed that the tongue coating color value and the tongue coating thickness in the PD group during the menstrual phase were significantly lower than those of the control group (P = 0.031 and P = 0.029, resp.). Conclusions These results suggest that the tongue features obtained from the CTIS may serve as a supplementary means for the differentiation of syndromes and the evaluation of therapeutic effect and prognosis in PD. Trial Registration This trial was registered with Clinical Research Information Service, registration number KCT0001604, registered on 27 August 2015.

Evaluation of the Bacterial Diversity in the Human Tongue Coating Based on Genus-Specific Primers for 16S rRNA Sequencing.

The characteristics of tongue coating are very important symbols for disease diagnosis in traditional Chinese medicine (TCM) theory. As a habitat of oral microbiota, bacteria on the tongue dorsum have been proved to be the cause of many oral diseases. The high-throughput next-generation sequencing (NGS) platforms have been widely applied in the analysis of bacterial 16S rRNA gene. We developed a methodology based on genus-specific multiprimer amplification and ligation-based sequencing for microbiota analysis. In order to validate the efficiency of the approach, we thoroughly analyzed six tongue coating samples from lung cancer patients with different TCM types, and more than 600 genera of bacteria were detected by this platform. The results showed that ligation-based parallel sequencing combined with enzyme digestion and multiamplification could expand the effective length of sequencing reads and could be applied in the microbiota analysis.

Diagnostic Method of Diabetes Based on Support Vector Machine and Tongue Images.

Objective. The purpose of this research is to develop a diagnostic method of diabetes based on standardized tongue image using support vector machine (SVM). Methods. Tongue images of 296 diabetic subjects and 531 nondiabetic subjects were collected by the TDA-1 digital tongue instrument. Tongue body and tongue coating were separated by the division-merging method and chrominance-threshold method. With extracted color and texture features of the tongue image as input variables, the diagnostic model of diabetes with SVM was trained. After optimizing the combination of SVM kernel parameters and input variables, the influences of the combinations on the model were analyzed. Results. After normalizing parameters of tongue images, the accuracy rate of diabetes predication was increased from 77.83% to 78.77%. The accuracy rate and area under curve (AUC) were not reduced after reducing the dimensions of tongue features with principal component analysis (PCA), while substantially saving the training time. During the training for selecting SVM parameters by genetic algorithm (GA), the accuracy rate of cross-validation was grown from 72% or so to 83.06%. Finally, we compare with several state-of-the-art algorithms, and experimental results show that our algorithm has the best predictive accuracy. Conclusions. The diagnostic method of diabetes on the basis of tongue images in Traditional Chinese Medicine (TCM) is of great value, indicating the feasibility of digitalized tongue diagnosis.