{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:30:59Z","timestamp":1791909059689,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,11,29]],"date-time":"2012-11-29T00:00:00Z","timestamp":1354147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gerodontology"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the causative factor behind the formation of membranous substances in the mouths of elderly patients requiring nursing care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Membranous substances are sometimes observed in the mouths of elderly persons requiring nursing care, and these can lead to bleeding, infection and asphyxiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>In <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>pril 2007, samples were collected from 70 patients at <jats:styled-content style=\"fixed-case\">C H<\/jats:styled-content>ospital, <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ichi <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>refecture, <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apan, who were 65\u00a0years or older (median age, 81.1\u00a0\u00b1\u00a07.7\u00a0years). Sixteen of the subjects were confirmed to have a membranous substance containing a keratin degeneration product that had been derived from stratified squamous epithelium. The samples were examined microscopically, and the presence of epithelial components was confirmed through immunohistochemical staining with anti\u2010cytokeratin\u20101 antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Decision tree analysis and logistic regression suggest that the leading contributors to the formation of the membranous substances were the method of ingesting nutrients, dryness of the tongue dorsum and open mouth. These three factors are related to elderly persons requiring nursing care with impaired oral cavity function, and it was suggested that dryness of the oral mucosa was the major factor behind the membrane formation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ger.12020","type":"journal-article","created":{"date-parts":[[2012,11,30]],"date-time":"2012-11-30T05:05:06Z","timestamp":1354251906000},"page":"184-193","source":"Crossref","is-referenced-by-count":18,"title":["Factors affecting the formation of membranous substances in the palates of elderly persons requiring nursing care"],"prefix":"10.1111","volume":"31","author":[{"given":"Yuka","family":"Kawase","sequence":"first","affiliation":[{"name":"Department of Dentistry Chiaki Hospital Medical Corporation Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Special Patient and Oral Care Matsumoto Dentistry University Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Kawase","sequence":"additional","affiliation":[{"name":"Department of Special Patient and Oral Care Matsumoto Dentistry University Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Wakimoto","sequence":"additional","affiliation":[{"name":"Department of Special Patient and Oral Care Matsumoto Dentistry University Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Special Patient and Oral Care Matsumoto Dentistry University Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fa\u2010Chih","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Dentistry Sijhih Cathay General Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromasa","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Oral Pathology Matsumoto Dentistry University Nagano Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuaki","family":"Kakinoki","sequence":"additional","affiliation":[{"name":"Division of Oral Care and Rehabilitation Department of Physical Functions Kyushu Dental College Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,11,29]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167-4943(95)00672-9"},{"key":"e_1_2_7_3_1","first-page":"88","article-title":"Improving findings in the mouth of elderly persons with open mouth at all times by oral moisturizers","volume":"36","author":"Yoshida R","year":"2006","journal-title":"Jpn J Nurs Soc: Geriatr Nurs"},{"key":"e_1_2_7_4_1","first-page":"647","article-title":"[You can do it in your institute too! 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