• Journal of Oral Medicine and Pain
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• v.47 no.4
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• pp.183-188
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• 2022

Purpose: The goal of this study was to investigate the causative factors related to the stress of temporomandibular disorders (TMDs) by evaluating salivary cortisol concentration in young adult TMD patients and control groups. Methods: Saliva was obtained from 32 young adult TMDs patients and 34 control patients without a history of TMDs who visited Chosun University Dental Hospital between June 1 and August 31, 2021. Enzyme-linked immunosorbent assay was conducted to measure the salivary cortisol concentration. Results: The salivary cortisol concentration in the TMD patient group and the control group differed significant significantly (p<0.05). The salivary cortisol concentration according to the duration of the clinical symptom of TMD differed significantly difference between the two groups in the male. The salivary cortisol concentration according to perceived stress level differed significantly in the mild and moderate groups (p<0.05). There was no significant difference in salivary cortisol concentration between the two groups related to bruxism or clenching (p>0.05). Conclusions: The salivary cortisol concentration in the TMD patient group and the control group showed statistical relevance, indicating that stress was a causative factor.

• Journal of Korean Biological Nursing Science
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• v.18 no.1
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• pp.9-16
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• 2016

Purpose: The purpose of this exploratory study was to find a specific time of day with a stable cortisol level and to investigate the relationship between salivary cortisol and sleep. Methods: A total of 36 Korean female college students participated in the study. Salivary specimens were collected 6 times a day for 2 days in different stressful situations. Sleep characteristics were measured using an actigraph while salivary specimens were collected. Perceived stress was evaluated using the Global Assessment of Recent Stress. Results: Depending on whether there were morning peak and/or afternoon elevations in the cortisol levels, the type of diurnal cortisol pattern was classified into 4 types. None of the cortisol levels in different times of the day showed significant relationships to perceived stress levels. Cortisol levels in the morning, levels of peak cortisol and diurnal differences of cortisol were significantly correlated with sleep duration. The time with most stable cortisol level was 9-10 pm. Conclusion: It is recommended that measurements of salivary cortisol are taken from 9-10 pm since it showed a stable value regardless of diurnal cortisol rhythm and sleep. Sleep duration should be considered as an important confounding factor in measuring cortisol levels in the morning and the diurnal differences of cortisol.

• Journal of Korean Biological Nursing Science
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• v.19 no.3
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• pp.206-213
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• 2017

Purpose: The purpose of the study was to compare salivary cortisol levels, self-reported occupational stress, and anxiety before duty to those after duty in the shift and regular work nurses, and the relationships among them. Methods: Thirty nurses working in a tertiary hospital participated in the study. Salivary specimens were collected before and after daytime duty for 2 days. The occupational stress and state anxiety were also evaluated using self-report questionnaires. Results: The average level of salivary cortisol was $0.40{\mu}g/dL$ before duty and $0.20{\mu}g/dL$ after duty in Korean nurses. Overall levels of salivary cortisol, self-reported occupational stress, and anxiety were higher in shift working nurses than regular working nurses. In shift working nurses, the salivary cortisol gap between before and after duty was attenuated on the first day of daytime duty. Significant positive correlation was found between the level of cortisol before duty and anxiety after duty. Conclusion: Strategies to alleviate occupational stress and anxiety are needed for shift working nurses, especially for those with elevated levels of cortisol. It seems to require 3days to recover from attenuated cortisol rhythm during nighttime duty in shift working nurses.

• Journal of Preventive Medicine and Public Health
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• v.42 no.4
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• pp.231-236
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• 2009

Objectives : This study was conducted to determine the appropriate sampling time of the salivary stress markers, chromogranin A (CgA) and cortisol as objective indices of job stress assessment in adult females. Methods : The subjects were 20${\sim}$39-year-old women (13 office workers, 11 sales-service workers, and 11 college students) who were eligible for the study and free of acute and chronic medical conditions. Salivary CgA and cortisol levels were determined by enzyme-linked immunosorbent assay (ELISA). Saliva samples were collected (2 $m{\ell}$ each) at 7:00, 8:00, 10:30, 12:00, 17:30, and 22:30 on a typical day. Salivary CgA and cortisol levels, according to sampling time, were compared among the three groups using general linear model. The full version of the Korean Occupational Stress Scale (KOSS), which includes socioeconomic characteristics, health behavior, workrelated characteristics, and BMI, was used to access the subjects' job stress. Multiple regression analysis of the job stressors identified by the KOSS was performed on salivary CgA and cortisol levels. Results : The salivary CgA level peaked at 7:00 (time of awakening), then decreased and were maintained at a low level throughout the day, and increased slightly at 17:30. The salivary cortisol level increased steeply within the 1st hour after awakening, followed by a gradual decrease by 12:00, and was then maintained at a low level throughout the day. The salivary cortisol levels of subjects who worked ${\leq}$5 days per week and graduated from the university were significantly lower at 8:00 (p=0.006). The salivary cortisol levels of non-smokers were significantly lower at 7:00 p=0.040) and 8:00 (p=0.003) compared to smokers. There were no significant differences in salivary CgA and cortisol levels at 10:30 and 12:00 in general characteristics. The regression coefficients on salivary CgA level were significant with interpersonal conflict at 17:30 and job insecurity at 22:30. Regression coefficients on salivary cortisol level were significant with organizational system and total job stressors at 17:30. Conclusions : We suggest that the appropriate sampling times for the salivary stress markers, CgA and cortisol, are at 7:00 (time of awakening), 8:00 (1 hour after awakening), 17:30 (early evening), and 22:30 (before sleep).

• Korean Journal of Veterinary Research
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• v.36 no.3
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• pp.731-741
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• 1996

ELISA kit for cortisol was developed and then evaluated. Polyclonal antihydrocortisone-3-(o-carboxymethyl)oxime BSA rabbit serum was used to coat the 96-well microplates. The minimum detection limit of the kit was 250pg of cortisol per milliliter. The within-run variation and the day to day variation of the ELISA system were 2.0 and 5.9 at maximum, respectively. The kit was used to determine whether salivary cortisol concentration could replace blood cortisol concentration in dexamathasone suppression test of dogs. Changes of cortisol concentration were measured in serum or saliva after intravenous administration of 0.01mg of dexamethasone per kilogram of body weight. Blood alone, saliva alone or both were collected at 0, 30, 60, 120, 240, and 360 minutes after injection of dexamethasone. The change in blood cortisol concentration was found to be suitable in dexamathasone suppression test of dogs, but the change in salivary cortisol concentration was not. The kit was also used to determine whether salivary cortisol concentration could be a stress index as well as blood cortisol concentration in dogs. Two types of trial were performed to estimate the stress either by blood or salivary cortisol concentration. The first trial was stress experiment by intravenous injection of 0.2IU of PZI-insulin per kilogram body weight. Either blood alone or saliva alone was collected at 0, 30, 60, and 90 minutes after insulin administration. Both blood and salivary cortisol concentration were found to be suitable index in estimating stress from hypoglycemia by injection of insulin. The second trial was stress experiment by electrical irritation. The dogs were irritated with anti-bark device for 10 seconds. Blood was collected before and at 2 and 5 minutes after electrical irritation. Saliva was collected before and at 3 and 6 minutes after electrical irritation. The blood cortisol concentration, but not the salivary cortisol concentration was found to be suitable index in estimating stress from electrical irritation. Cushing syndrome in a dog was also successfully diagnosed with this kit.

• Journal of the Ergonomics Society of Korea
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• v.26 no.1
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• pp.11-18
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• 2007

The physiological and biochemical responses of healthy men and women to life stress were measured in order to temperature, blood pressure (BP), heart rate (HR) and galvanic skin response (GSR) were selected as physiological stress indices and salivary cortisol level was used as a biochemical stres biomarker. Twenty six (male 14 and female 13) colege students were participated in the experiment. Female showed the significant higher value of salivary cortisol level (p<0.01), diastolic BP (p<0.01), and HR (p<0.01) than male. The difference of skin temperature between forehead and fingertip correlated significantly with salivary cortisol level (p<0.01). The LF(low frequency)/HF(high frequency) ratio of HRV also correlated significantly with salivary cortisol level (p<0.01). However, BP, HR and GSR corelated insignificantly with salivary cortisol level. We suggest that LF/HF ratio of HRV and skin temperature may be good indices for the assessment of life stress, and may apply to measure the stress level of individual in real time.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.2
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• pp.223-232
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• 2014

Most of salivary cortisol are an unbound free form reflecting physiological function later. Thus, it is used frequently to evaluate the HPA-Axis and physiological function. Although the needs of salivary cortisol measurement in Korean Medicine is higher and higher, there are not many studies, because the reliability of salivary cortisol measurement is not high. To make the reliability high and encourage to use it in Korean Medicine, the goal of this study is to suggest the standard method of saliva collecting for cortisol measurement through the review of previous studies using salivary cortisol and to encourage to use it in clinical fields in Korean Medicine. The results are as followed; First, salivary cortisol has many benefits, i. e. easy collecting, non-invasive collecting, and reflecting the physiological function. Second, the collecting time and method are kept sternly, because the methods of saliva collecting vary depending on the goal of study. Third, the specific tools for saliva collecting are recommended to prevent contamination. In conclusion, if the standard methods of saliva collecting is kept to measure salivary cortisol, it would be very useful in many fields of Korean Medicine.

• BMB Reports
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• v.43 no.7
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• pp.506-511
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• 2010

The levels of salivary cortisol and cortisone in Korean adults were measured for the first time using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The salivary cortisol and cortisone were separated within 10 min. The regression coefficients (r) of the calibration curves were greater than 0.999 for the two steroids. The limits of quantitation (LOQ) were 0.2 ng/ml for cortisol and 1 ng/ml for cortisone. The intra-day precisions of the assay were <3.9% and 8.6% for cortisol and cortisone respectively, and the inter-day precisions were <1.9% and 4.3% for cortisol and cortisone, respectively. The salivary cortisone concentrations were approximately 4-9 times higher than those of salivary cortisol during the daytime. Diurnal rhythms, during which the cortisol and cortisone concentrations were higher in the morning than in the afternoon, were also observed. The present assay may be useful for the diagnosis of several adrenal dysfunctions in clinical biochemistry.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.2
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• pp.131-142
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• 2008

Objectives : This study was performed to identify the influence of salivary cortisol and HRV(Heart rate variability) on hypoadrenia predisposing factors and sign. Methods : 30 patients with chronic fatigue symptom belonging to Shen xu(腎虛) were recruited for investigation from March to April 2007. The participants were divided into HS(High score) group(n=15) and LS(Low score) group(n=15) in predisposing factors of adrenal questionnaire. At the same time equal patients separated into OH(+)(Orthostatic hypotension positive) group(n=12) and OH(-)(Orthostatic hypotension negative) group(n=18). Salivary cortisol and HRV made use of evaluating hormonal imbalance and autonomic nervous system of hypoadrenia. Results : Salivary cortisol at P.M.4 in HS group was significantly(p=0.011) lower than LS group. And LF(Low frequency) of OH(+) group was considerably(p=0.014) lower than OH(-) group. Conclusions : Shen xu bian zheng(腎虛辨證), measure of orthostatic hypotension, predisposing factors of adrenal questionnaire, salivary cortisol and HRV deserve clinical application for management of subclinical hypoadrenia.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.30-34
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• 2014

Background: Myofascial pain dysfunction syndrome (MPDS), otherwise called myofascial pain is one of the most common temporomandibular disorders, which in turn is the most common cause of orofacial pain of non-dental origin. Its etiology is multifactorial and still poorly understood. Psychological factors have been shown to play a role in the etiology. The aim of the study was to evaluate the association between anxiety and salivary cortisol levels in patients with myofascial pain. Methods: Twenty patients suffering from myofascial pain were recruited as the study group. The same number of age and sex matched healthy individuals were taken as the control group. The salivary samples collected between 9-9:15 am from both groups were analyzed for cortisol levels with the competitive enzyme-linked immunosorbent assay method. Anxiety levels of 40 patients were measured using Hamilton's anxiety scale. Results: The mean serum cortisol level of the MPDS group showed a highly significant difference (P < 0.001) from the controls. The mean anxiety scores of the MPDS group showed a highly significant difference (P < 0.001) from the controls. A positive correlation was found between anxiety and the salivary cortisol levels in MPDS patients. Conclusions: These findings suggest that anxiety plays a vital role in the etio-pathogenesis of MPDS; thus, besides pharmacological treatment, psychological support is also needed.