In this article, the ability of denture handling was evaluated by means of measurement of the time required to insert upper and lower dentures into the mouth, in the subjects of two groups: the patient group consisted from 61 psychiatric and neural disease patients and the normal group of 17 subjects. In the patient group, all cases except a cerebrovascular patient had experienced dentures on the point of this investigation. The each group was subdivided into two groups: Group 1; full denture wearing group and Group2; combination of partial and partial/full denture (table 1). The diseases of the patient group included schizophrenia (n=21), Parkinson's disease (n=9), cerebrovascular disease (n=8), alcoholic dipendence (n=7), mood disorders (n=6), and so on (table 2).
The results were as following (figure 1):
1) The subjects of the normal group inserted their dentures between 3 to 11 seconds, and the mean of the time required was 6.9±2.0 seconds. On the other hand, the subjects of the patient group were scattared on wide range from 3 to over 356 seconds.
2) In order to evaluate the influence of the disease toward the ability of denture handling, in each group of Group 1 and Group2, the time required in the normal group wascompaired with the one of the patient group. In Group 1, the mean of the time required in thepatient group was 16.7±15.6 seconds, and longer than the one in the normal group that was 7.0±1.0 seconds. The difference was not significant (P<0.05). In Group 2, the mean time in the patient group was 23.7±17.9 seconds, and significantly longer than the one in the normal group that was 6.9±2.4 seconds (P<0.05).
3) In order to clarify the influence of denture form on the time required, in each group of the normal group and the patient group, Group 1 was compaired to Group 2. In the normal group, there was no difference between the two groups. In the patient group, the mean time required in Group 2 was 23.7±17.9 seconds and longer than the one in Group 1, that was 16.7±15.6 seconds, but the difference was not significant (P<0.05).
4) Diseases of the five cases required over sixty seconds to insert dentures included a Pakinson's disease, a cerebrovascular disease, a myotonic dystrophy, an alchoholic dependence and a schizophrenia. These cases suggested various factors essential to finish the action of denture inserting.

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There were 1, 280 patients, who were the inpatients at Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical Collage from 1986 to 1991. Among 511 patients (39.9%) had systemic diseases of some kind or others.
The average age of the medically compromised patients was 49.1 years. The ratio of the medically compromised patients increased with their age and amounted 88.6% in the patients of the seventies.
In a classification by type of diseases, the patients with circulatorydiseas-es were overwhelmingly many, accounting for about a half of all. Next followedendocrine and metabolic diseases, digestive tract diseases, etc.
Among the 511 patients, 129 (25.2%) were caries and periodontitis, 105 (20.5%) were tumors, 97 (19.0%) were traumas, 77 (15.1%) were inflammatory disorders, 45 (8.8%) were cysts, and 58 (11.4%) were others.
The number of operations were 425, and 204 (48.0%) of them were performed under general anesthesia and 221 (52.0%) were under local anesthesia.

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There were 732 inpatients in department of oral and maxillofacial surgery, Health Sciences University of Hokkaido during past 10 years from April, 1st, 1983 to March, 25th, 1993.
Among them, 314 patients (42.9%) had underlying diseases (429) of some kind or the other. There were 153 male and 161 female patients, and these were 41.6% and 44.2% of the inpatients respectively.
The average age of the patients was 44.6 years, while that of all subjects was 38.0 years.
In the number of the diseases per medically compromised patient, there were 221 patients (70.4%) with a single disease, 93 patients (29.4%) with two or more diseases.
In the classification by types of diseases, cardiovascular diseases were the most common (31.9%). Next followed psychoneurotic diseases (16.6%), metabolic diseases (9.6%), hematological diseases (8.2%), etc.
In age groups, the most common disease under thirties was psychoneurotic and over forties was cardiovascular.
In connection with the finding out the underling disease. 87.2% was showed from the past medical history and status praesens of the patients, while 12.8% was found from laboratory studies.
Hematological diseases and digestive tract diseases were hard to find.
Two handred nineteen diseases (51.4%), that had been under pt's doctor, continued the medical treatment.
Fortyfive (10.5%) out of another two handred ten diseases (48.6%) required to be treated anew.

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The mucosae of thirty-seven patients with hemophilia of our outpatients clinic were examined clinically by means of cultivation using Microstix-Candida ^® to determine the presence of Candida albicans. Eighteen (48.6%) out of thirty-seven men were seropositive for human immunodeficiency virus (HIV).
The other nineteen patients were HIV seronegative. Five out of eighteen (27.8%) HIV seropositive and one out of nineteen (5.3%) HIV seronegative patients had culture-confirmed presence of C. albicans.
In the former group, colonization of C. albicans was significantly more frequent in subjects with lymphocytopenia, CD4+ cell deleption, reversed CD4/CD8 rate and elevated DMF index. We did not find the relationship, on the other hand, between score of OHI-S and prevalence of C. albicans from oral cavity. Our findings indicate that oral candidiasis occurs in HIV infection as a result of C. albicans over-growth, and conclude that clinician should be aware of importance of cooperation with dentists and management of dental hygiene.

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We report a case we encountered, who required implant removal due to th incapability of self-maintenance of oral hygiene as a result of hemiplegia occurringas a sequela of cerebral infarction.
The case was a 76-year-old man wearing a fixed bridge implanted 10 years ago between remaining teeth. This patient had cerebral infarction 2years ago and developed right motor impairment and central facial paralysis as sequelae, although he survived. After the onset of cerebral infarction, he became incapable of maintaining oral hygiene, resultihg in persistent pus discharge and swelling around the implant.
Needless to say, since aged patients, for whom implants are indicated, and those required a high degree of maintenance of oral hygiene will inevitably increase, it is inferred that patients requiring implant removal due to insufficient maintenance of oral hygiene as a result of systemic disease, like as this case. Thus the system that can maintain oral hygiene under control, even if the patients unfortunately fall in poor systemic condition, shoud be constructed.

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It is generally accepted that the presence of poorly controlled diabetes mellitus (DM) likely contributes to the incidence and severity of infection. Among others, necrotizing fasciitis is serious infection characterized by rapidly spread and severe gangrene of the superficial fascia.
We have experienced a case of maxillofacial necrotizing fasciitis of patient with poorly controlled DM. A 60-year-old man with DM was referred to our hospital with severe pain and swelling of right submandibular region. The inflammation might be originated from acute pericoronitis of the right lower third molar. Not only improving the general condition of patient by administration of anitibiotics and control DM, if compromised, but early diagnosis and extensive surgical debridement are very important treatment for necrotizing fasciitis.

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Many patients with chronic hemodialysis have electrolyte disorders, cardiovasc-ular disease, hypertension, renal osteodystrophy, develop infections, anemia and hemorrhagic tendency.
Therefore, oral surgeons must be aware of any risk of hemodialysis at surgers. We encountered two cases underwent hemodialysis who died after operation for oral lesion.
Case1; A 58-year-old man with a history of hypertension and chronic hemodialysis was admitted to our hospital on April 2, 1990. because of operation of left mandibular cyst.
On April 4, under general anesthesia the left mandibular second and third molars were extracted and the mandibular cyst was removed without complication. The postoperative courses were satisfactory. Sixth day postoperative, directly after the hemodialysis, bloood pressure elevated at the level of 216/120mmHg.
The patient suddenly have a convulsive fit and so lose consciousness. A CT scan of the brain showed a large right thalamus hemorrhage. After a consultation with the internist, the patient was transferred to the ICU. Three weeks after operation, the patiant diet of cerebral hemorrhage.
Case 2; A 60-year-old man with a history of angina pectoris, gout, chronic renal failure, an aneurysm of the abdominal aorta, liver cirrhosis, anemia and thrombocytopenia was admitted to our hospital. The patient has been undergoing dialysis treatment since 7 years ago. The patient has noticed intermittent oral bleeding for about eight months. But the patient complains of oral bleeding all the time in the last week. So, the patient was firmly wished to extraction of teeth as causal treatment.
On Novenber 11, the maxilla right first molar, second molar and the mandibular right second molar were extracted under local anesthesia. We were used the insertion of Gelatin into the socket and the closure of the wound by suture, and used the application of surgical packs and hemostatic splint.
After the extraction induced persistent oozing. Pressure packes of gauze spoonges saturated with topical thrombin were effective for a time, but bleeding recurred. Mental activity was reduced and the patient became drowsy. The blood pressure elevated 176mmHg systaltic. Next morning, the patient died of massive hemorrhage because of exprosion of aneurysm of the abdominal aorta.

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