Apoptosis plays an important role in such biological processes as multistep carcinogenesis. Human papillomavirus type 16 (HPV16) -immortalized human epithelial cell lines are, for the most part, nontumorigenic in nude mice and useful for studying mechanisms involved in multistep carcinogenesis. We previously reported that HPV16-immortalized human laryngeal epithelial cell line HLEC16 formed tumors after treatment with 4- (methyl-nitrosamine) -1- (3-pyridyl) -1-butanone, and derived one tumorigenic cell line, HLEC16T. We compared sensitivity to Fas receptor-mediated apoptosis of nontumorigenic HLEC16 and tumorigenic HLEC16T. HLEC16 and HLEC16T expressed Fas protein (Fas) but not Fas-ligand (FasL) mRNA. We applied an anti-Fas monoclonal, antibody, CH11, to HLEC16 and HLEC16T, and monitored cell death. HLEC16T was found to be significantly less sensitive to CH11-mediated cell death that HLEC16. Western blot analysis showed no significant difference in levels of apoptosis-inducing protein, Bax, between HLEC16 and HLEC16T. Levels of apoptosis-inhibiting proteins Bcl-2 and Bcl-X_L increased in HLEC16T. These results suggest that the inhibition of Fas-mediated apoptosis through apoptosis-inhibiting protein overexpression may promote tumorigenicity in HLEC16T.

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Streptococcus constellatus, S. intermedius, and S. anginosus, the three species of the S. milleri group, form part of the normal flora most commonly found in the mouth, throat, gastrointenstinal tract, and genital tract. The S. milleri group has become known as an important pathogen in abscess disease, but little attention has been paid to their role in deep neck abscesses. We have treated 9 patients with deep neck abscesses relating to the S. millerigroup since 1991, and regarded this group as an important pathogen also in these abscesses. We studied the frequency of the S. milleri group isolated from deep neck abscesses in our cases and from the literature and discuss clinical significance and bacteriological pathogenesis. Cases numbered 27 treated at our facility since 1991 and 200 cases reported in the Japanese literature since 1990.
Of our 9 cases, 4 originated from acute pharyngitis, 3 from peritonsillar abscesses, and 2 from odontogenic infection. Serious complications such as mediastinitis, cervical necrotizing fasciitis, sepsis accompanied by disseminated intravascular coagulation, and spondylitis of the cervical vertebrae were seen in 4 cases. Among organisms isolated, the S. milleri group appeared to be a pathogen contributing to abscess formation and to serious complications.
The genus Streptococcus was most frequently isolated both in our 27 cases (66.7%) and the 200 in the literature (45.5%). Among species of the genus Streptococcus, the S. milleri group numbered the highest in our cases at 33.3% but only 8.5% in the literature. Cases in the literature, however, contained many unknown species of Streptococci -31.5% vs. 18.5% in our cases. α-streptococcus was frequently reported in the literature among unknown species of Streptococci -36 of 63. Culture-negative cases were also numbered more in the literature than in our case -29.0% vs. 18.5%.
Special conditions and procedures are required to suitably isolate and detect the S. milleri group. Since not all facilities use identical techniques in routine bacteriological examination, a considerable number of the S. milleri group could be missed in unknown species of Streptococci or α-streptococcus and culture-negative cases.
The detailed pathogenesis of the S. milleri group remains to be clarified. Infection by normal flora on mucosa is thought to occur due to an imbalance between organisms and host defense in deep neck abscesses. Some strains of the S. milleri group have been reported to produce many tissue-destroying enzymes such as collagenase and hyaluronidase. The co-existence of the S. milleri group with some anaerobe strains has also been suggested to accelerate inflammation. We discuss the mechanism inducing the massive release of cytokines through T cell response to certain exotoxins produced by the S. milleri group, as reported in toxic shock-like syndrome due to the group A β-streptococcus and in α-streptococcal shock syndrome due to viridans streptococci (α-streptococci).

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We treated 227 patients, 45 men and 182 women, with thyroid carcinoma at our hospital from 1984 to 1998. Of these, 177 had papillary carcinoma and 50 follicular carcinoma.
The extent of resection was based on tumor size in papillary carcinoma but not follicular carcinoma, and 70% of carcinoma patients underwent hemithyroidectomy.
Neck lymph nodes were resected in 93.2% of papillary carcinoma patients, with D1 neck dissection in 45.7% and D2 or D3 neck dissection in 47.5%. In contrast, 70% of follicular carcinoma patients with lymph node resection had D1 dissection. Locoregional recurrence was noted in 22 patients and distant metastasis in 6 cases.
Nonsurvivors numbered 17, 12 papillary and 5 follicular carcinoma patients, died of their primary disease. Almost all deaths were in patients with advanced disease, pT₃ in 3, pT₄ in 10, N1a in 3 and Nlb in 8.
The prognostic factors for papillary caracinoma were extracapsular spread, age, and distant metastasis, while the only factor for follicular carcinoma was distant metastasis.
The 5-year survival for patients with papillary carcinoma was 93.0% and 10-year survival 88.8%, compared to 5-year survival for 93.5% of follicular carcinoma patients and 10-year survival for 93.5%.

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Objective: Japanese people are physically larger and live longer than in the past. In light of these changes, we studied anthropometric auricular morphology in Japanese people in all age groups.
Methods: Subjects were 1, 958 healthy Japanese people with no ear disease, 966 males aged 0-94 years and 992 females aged 0-99 years. They were classified at 5-year intervals into 18 age groups, and each group consisted of 50-72 persons. Bilateral size of auricles (ear length, ear width, length of ear attachment, auricular cartilage length, and auricular lobe length) were measured in the usual manner. All measurements were made with calipers by a single observer.
Results: Larger values were obtained in males than in females in almost all age groups. Rapid growth was observed until late teenage, and significant growth continued thereafter until advanced age. Auricular size was found to be greater than that in Japanese people in the past.
Conclusions: In addition to changes in auricular size believed attributable to growth until late teenage, ageassociated changes appear to continue during adulthood.

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