In advancing the clinic/hospital referrals, questionnaires were administered to private clinicians and hospital dentists, to grasp their level of awareness, and the reality faced by them, and the current state of the dental department in the hospital
As a result, the following points came to light;
The summary of problems in the current stages are as follows:
1: There is a need for secure, appropriate positioning of referred dentists (ie. hospital dentists) within the district.
2: The expansion of hospital facilities and staff of the dental department are required.
3: The dissolving of problems of un-profitability at the dental departments in the hospital is desired.
In order to provide high quality and appropriate dental service in the district, there is a need to strengthen and restructure the hospital dental treatment services offered by the referred dentists. Furthermore, there is a need to clarify the extent of services offered by the referred dentists, and secure the provision of comprehensive health service.

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There were 107 patients with malignant tumor of the oral and maxillofacial region, who were treated in Department of Oral and Maxillofacial Surgery, Yamaguchi University from 1990 to 1995. Of these patients, 70 were men, and 37 were women. The average age of them was 62.5 years. Among them, 66 patients (61.7%) had systemic diseases of some kind or others. In a Classification by type of diseases, 39 patients (34.8%) had digestive tract diseases, that were most common. Next followed 35 patients (31.3%) had cardiovascular diseases. Thirty eight patients (57.6%) had an underlying diseases, 16 patients (24.2%) had two, and 12 patients (18.2%) had more. Only two of all patients had to change the treatment because of their systemic diseases. Five year absolute survival rates were 58.3% in all patients. As the number of systemic disease increased, 5 year absolute survival rates were lower.

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Medically compromised patients under a long-term treatment for plural basal diseases were selected as subjects, and examination of bacteria and mycoses was made and frequency of identification of mycoses, Candida in particular, was investigated.
Examination was made in 375 patients (199 males and 176 females) from 33 to 89 years old. Samples were taken from the tongue, gingiva, buccal mucosa, palate mucosa and saliva.
Candida was identified in 234 patients (123 males and 111 females) or in 62.4%. By the kind of mycoses, Candida albicans was identified in 214 patients or in 91.5%. Identification of Candida albicans alone was seen in 132 patients or in 56.4%, which was the most frequent. Candida albicans and some other mycoses were isolated in 82 patients or in 35%. In the cases where plural kinds of mycoses were isolated, identification of two kinds of mycoses, Candida albicans and Candida glabrata, was seen in 65 patients or in 79.2%, which was the highest. Then, identification of three kinds, Candida albicans, Candida glabrata and Candida tropicalis was seen in 11 patients or in 13.4%. No Candida albicans was identified in 20 patients or in 8.5%. The kind identified in these patients was mostly Candida glabrata.

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In this study, we evaluated general condition prior to or in conjunction with dental treatment for the Rheumatoid Arthritis (RA) patients who visited department of rheumatology periodically as an outpatient and also hoped to be treated at department of dentistry, Kumamoto city hospital, by examining their medical charts exactly.
The results obtained were as follows:
1) The number of the patients who were evaluated was 212. Among them, 93 patients noted that they had history of having complication in our consultation records. The patients with hypertension were most frequent (30), followed by ones with gastric ulcer (23), In fact, however, 140 patients were diagnosed and treated mainly by physicians as to their general diseases which may affect dental treatment. Among them, the Patients with gastric ulcer were most frequent (45), followed by ones with hypertension (35).
2) The averaged number of the medicines which were prescribed for the patients was approximately 4.73. Nonsteroidal antiinflammatory drugs, corticosteroids, antirheumatic drugs were used against RA, and the number of the patients who were prescribed was 151, 113 and 117 respectively.
3) As to the laboratory studies, about one third of all the patients exihibited extraordinary levels in hemoglobin count and albumin, blood urea nitrogen, and creatinine in serum. It was significantly noted that 160 patients showed lower level as for ferrum in serum. There were 44 patients who was pointed up necessity of reexamination by cardiologist in 102 ones who were taken ordinary electrocardiogragh before their medical treatment.
4) Comparison of laboratory findings between the patients with corticosteroids and ones without the medicines; There was significant difference in averaged number of white cell count and platelet count and level of ferrum in serum between two groups.
We noticed that the patients with corticosteroids had extraordinary findings in white cell count and level of albumin and ferrum in their serums more than another group.
On the basis of the results above, we recognize that we not only have to encourage the patients fill in consultation sheets enough much and exactly to know their past medical history, but also have necessity to refer the patients to rheumatologist each other so frequently that we can accept important information about their laboratory findings and contents of medical treatment towards the patients.

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There were 2, 023 aged patients (over 65-years old), who were the outpatients at Department of Oral and Maxillofacial Surgery Tokyo Women's medical University School of medicine from 1994 to 1997.
Among 1, 623 patients (80.1%) had systemic diseases of some kind of others.
In the number of the diseases per medically compromised patient, there were 924 patients (57.0%) with a single disease, 699 patients (43.0%) with two more disease, and average number of diseases per patient was 1.58.
Among systemic diseases, circulatory diseases accounted for the largest fraction, affecting 1, 113 patients (43.5%), followed by neoplasms, endocrine and metabolic diseases and digestive tract diseases.
In the classification of diseases in the oral region, the majority were dentally related diseases, seen in 1, 206 patients (73.4%) followed by inflammatory diseases, tumors and injuries.
The most frequent provided was restorations and prosthetic treatment, followed by tooth extraction and scaling.

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Adult Stills disease, which is junior rheumatoid arthritis contracted by adults, was famous as one of the fever unknown origin disease. In oral and maxillofacial surgery, when we encounter a fever case after operation, we must consider about not only postoperative infection but also other feverish diseases. In this time, we experienced a case of adult Stills disease (Patient was 47years old man) with major symptoms being fever, arthrosis, and efflorescence and reported about detail of those.
This case was as follows. The day following the operation day, the patients fever had risen to over 40°C and he sprained his ankle and wrist. Then efflorescence his arm and legs, and it scattered. At first, we suspected that this fever was brought on by a sepsis of infection from the operated area. We administered some kind of antimicrobial by injection, however the fever did not go down, so he was injected with immune serum globulin simultaneously, but the fever did not subside. We referred to medical department for check the other complications. Therefore this case was diagnosed as adult Stills disease with major symptoms being fever, arthrosis, and efflorescence.

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