This paper presents an analysis of 4 cases of oral leukoplakia, identified over the last 17 years (1980-1996), that developed into squamous cell carcinoma. These cases included 2 males and 2 females; carcinoma was on the lateral tongue in 3 cases, and on the lower gum in 1 case. The mean period of malignant transformation was 3 years and 5 months. None of the patients smoked. An anticancer drug was administered prior to malignant transformation in each of the cases, but they failed to prevent malignancy.
Malignant trasnformation occurred on the tongue in 3 patients who had erosion or an ulcer either at the first visit or during the follow-up period. In the patient with carcinoma of the gum, the lesion showed several recurrences after removal.
The first biopsy revealed that dysplasia was moderate in 3 cases and severe in 1. The dysplasia score, based on the dysplastic criteria of the WHO (1978), progressed in all cases during the follow-up period.
Thus, strict follow-up examination is necessary in cases with such clinical and pathological findings at the first visit, or with such changes during follow-up.

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To examine the involvement of Candida albicans in burning mouth syndrome, we detected C. albicans by swab culture, along with the germ tube test, from swab samples of the lingual mucosa, and estimated the effect of antifungal therapy on yeast-positive patients. The subjects included 33 patients: 11 males and 22 females. Twenty-six healthy individuals with no oral mucosal disease were examined as a control group. The prevalence of C. albicans was higher in the disease group than in the control, at 48.5% and 34.6%, respectively, although there was no statistically significant difference. Oral rinsing with an antifungal agent reduced the burning sensation in 61.5% of the C. albicans-positive patients, and gave complete releif in 30.8%. These findings suggested that subclinical oral candidiasis might be involved in burning mouth syndrome. In conclusion, it is necessary to do a fungal culture in burning mouth syndrome patients, and if C. albicans is detected, antifungal therapy is recommended as the first therapeutic choice.

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The chronic graft-versus-host disease (cGVHD) reaction is known as one of the most serious complications following allogeneic bone marrow plantation (BMT) or peripheral blood stem cell transplantation (PBSCT), and it is a significant cause of morbidity and mortality in patients undergoing allogeneic transplantation. A lip biopsy specimen helps in making a more definitive diagnosis in the early stage of cGVHD, because histological findings in lip mucosa and labial salivary gland appear to reflect the early status of cGVHD better than other organs involved. In this study, we analyzed, immunohistochemically, oral biopsy specimens from four patients who had received allogeneic peripheral blood stem cell transplantation. Pathologic findings of oral mucosa and labial salivary glands were valuable in early recognition and follow-up of cGVHD. The results of TUNEL staining suggested that cell-to-cell contact-mediated apoptosis occurred in the oral epithelium and epithelial duct cells in the labial salivary gland of cGVHD.

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A 22-year-old female with a white lesion on the left side of the tongue is reported. This lesion was diagnosed as oral lichen planus, clinically and pathologically. In the patient's oral cavity, positive metal against patch test was detected by metal analysis of dental alloys. A topical steroid was ineffective; however, after the removal of dental alloys, the lesion disappeared. These findings strongly suggested that a dental alloy metal allergy led to the lesion.

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Angioneurotic edema (Quincke's edema) is characterized by acute subcutaneous or submucosal localization of edema. The exact cause of angioneurotic edema is not known.
The patient was a 65-years old-male who was referred to our hospital because of sudden swelling of the tongue. The patient was treated with dripintra-venous (DIV) infusion of antibiotic, and the symptom disappeared. It is considered that psychological factors could have caused the edema in this case, because no other possible causes were identifiable.

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