Roentgenographic observation of both hands was carried out to learn the bone age, incidence of the ossification center and onset time in 115 patients 6 to 12 years old with cleft lips and palates Results.
1) In the bone age of the cleft lip and palate, high carpal bone scores and had acceleration of the maturity ossification center were shown in each age as compared with those of the same age normal persons in both male and female. However, the degree of skeletal maturation was within the normal range.
2) The incidence of the carpal bone of the radius side and the distal end of the epiphysis center ulna with the cleft lip and palate was not only higher but also its onset time was earlier than in normal males and females of the same age.

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Epidermal growth factor (EGF) is a polypeptide hormone originally isolated from the mouse submaxillary gland (1962, Cohen). A similar molecule, which is functionally indistinguishable from murine EGF, is found in human tissues and body fluids. When injected into new bone mice, EGF elicits, among other things, the proliferation and differentiation of the epidermis. In-vitro studies also show that EGF has various biological activities on a wide variety of cell types including keratinocytes and fibroblasts. The effect of EGF occurs through cell surface receptors. The number of receptors expressed on the cell surface and the biological effect of EGF vary with cell types.
In the course of our research on oral cancer cell proliferation, it was found that EGF inhibited DNA synthesis in the oral cancer cell line Ca 9-22 SF. In the present study, the effect of EGF on five human oral cancer cell lines viz., Ca 9-22, NA, HSC 2, HSC 3 and HSC 4 was examined. Addition of EGF to the cultured medium of five cell lines resulted in a decrease in plating efficiency. Inhibitory effect was observed at 0.1ng/ml EGF and plating efficiency of each cell line decreased with the subsequent increase in concentration of EGF. At 10ng/ml EGF, NA and Ca 9-22 scarcely formed colonies. Growth inhibition was assessed by monitoring the cell number and it was found that addition of 1ng/ml EGF did not show so much effect on the growth inhibition on each cell line tested. However, presence of EGF at concentration of 10ng/ml was found to be markedly inhibitory for the growth of NA, Ca 9-22, and HSC 2 cells. Morphological observation was done with optical and phase contrast microscopes. Although none of the cell lines showed the remarkable change in cell morphology at 1ng/ml EGF, significant morphological changes such as spindle shape and formation of processes and appearance of granules etc., were noted in the presence of 10ng/ml EGF. The incorporation of ³H-histidine and ³H-TdR into each cell line was measured. The ratio of ³H-histidine to ³H-TdR on all cell lines showed no specific pattern. NA and HSC 4 showed a great increase of the ratio whereas Ca 9-22 and HSC 3 elicited little change.

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A lyophilized auricular cartilage graft and fresh auricular cartilage graft with sizes of 5×5mm and 5×10mm were homotransplanted into the subcutaneous tissue of the back, muscle of spinal erection and auricular portion of immature rabbits. Daily observation was executed about histological and histochemical changes of the rise and fall of grafts.
The results are as follows:
1) Lyophilized auricular cartilage grafts and fresh auricular cartilage grafts existed in the subcutaneous tissue, muscle and auricular portion for the 48-week observation period without being absorbed.
2) Cartilage cell proliferation and cartilage graft growth were observed in the fresh auricular cartilage but were not observed in the lyophilized auricular cartilage.
3) In the transplantation into the subcutaneous tissue, both lyophilized auricular cartilage and fresh auricular cartilage were covered with the fibrous connective tissue that differ from the subcutaneous tissue.
4) In the transplantation into the muscle, both lyophilized auricular cartilage and fresh auricular cartilage were covered with the muscular tissue and the grafts had affinity with the recipient tissue.
5) In the transplantation into the auricular portion, the new cartilage tissue was regenerated in the gap between the lyophilized auricular cartilage and the host cartilage, and between the fresh auricular cartilage and the host cartilage. The cartilage graft and the host cartilage were found to be joined by newly formed cartilage tissues. Newly formed cartilage tissues had no influence on the cartilage grafts.
6) The changes in sizes of the grafts show no difference in both the lyophilized auricular cartilage and fresh auricular cartilage.

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The three-dimensional personal computer graphics (DIM 3) was developedby the autheor.
Input data were traced out of the maxillofacial cranium shape of the CT films by the cursor pen on the digitizer, and the computer graphics image was reproduced on the CRT and X-Y plotter.
The reproducible accuracy of the graphics was satisfactory for use in diagnosis, surgical therapy planning and morphological studies in the field of maxillofacial surgery.

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Through the use of 119 3-month-old male hamsters the DNCB delayed type hypersensitivity (DTH) reactions to radiation exposure, doses of anticarcinoagents, and steroids on both normal hamsters and DMBA induced hamsters with tongue neoplasia were examined.
Skin of the hamsters' hind liras were sensitized with injections of 5% DNCB-Freund's Incomplete Adjuvant suspension 0.1ml below the skin. One week following the sensitization the skin of each hamster's abdomen was tonsured and comparative challeng testw ere conducted by performing one patch test of 0.5% DNCB acetone solution and another of 0.1ml saline solution for purposes of comparison. The tested portions were then examined 24 hours later.
On the untreated normal hamster's DNCB-DTH reactions, 94.9% were positive. The DMBA treated group's DNCB-DTH reactions after the prescribed amount of time had elasped, rose from 90% to 94. 7%. From these results it was surmised that positive-DNCB-DTH reactions were recognized in the DMBA sensitized, DNCB tested hamster group and that an antigeneicity common to both DMBA and DNCB existed. This showed the difficulty investigating degrees of cellular immunity through the DTH reactions of DNCB in the DMBA carcinogenic experimental group.
For 14 consecutive days Hydrocorcisone sodium succinate 10mg/kg, Predonisolone sodium succinate 6mg/kg, Cyclophosphamide 20mg/kg, and Tegaful 100mg/kg were injectedinto the peritoneal cavities of normal hamsters which recieved sensitization on the seventh day. On the fourteenth day test results proved that the positive DNCB-DTH reactions had not been decreased.
However, the decreas on DNCB-DTH reactions was recognized in the portion of the group which recieved radiation exposure (6 MeV, X-Ray 300 rad, single full body exposure) prior to, and following sensitization.

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With macrophage superoxide production as an index, the peritoneal macrophage function in the DMBA induced tongue neoplasia formation was examined using 114 5-weekold male hamsters. Hamsters from the DMBA treated group were killed in the fourth, eighth, eleventh, and fifteenth weeks. Hamsters from an untreated control group were also killed at these intervals. In order to determine the effects of ether anesthetic used during carcinogenic manipulation, another group was given ether anesthetic 3 times a week for eleven weeks then killed and examined. From the peritoneal cavity of each hamster macrophage was extracted and the superoxide was measured using the NBT reduction method. The results proved that there was no significance in superoxide production of the DMBA treated group in the various intervals. However, superoxide production of the DMBA treated group in the 11 th week decreased considerably compared with the untreated control group in the eleventh week. (p<0.05) This time period corresponded to the period of neoplasia autonomic increase aquisition reported by SHIGEOKA when compared with the untreated control group in its eleventh week the anesthetised group showd considerable decrease in production of superoxide (p<0.05). The infulence on immunity of ether anesthetic used for carcinogenic manipulation can not be ignored.

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A rare case of the first and second branchial arch syndrome was reported. The patient revealed a left facial hypoplasia, hypoplastic deformed small ear, and obstruction of the external acoustic meatus, and additionally, submucosal cleft palate was recognized. In the oral cavity, highly advanced many carious teeth, and cross-bite at the anterior portion were observed. Roentgenographically under development of the left mandibular ramus, deformity of the nasal septum, and enlargement of the mandibular angle were also shown.
It has been generally said on the genesis of this syndrome that developmental disturbance of mesodermal components of the first and second branchial arch would occur in the approximate 7 th week of the uterine life, however in this case, the clear cause was not clarified.
The patient was operated in the manner of usual cleft palate plastic surgery and has been trained in the speech therapy.

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Many cases of multiple carcinoma have been reported since Billroth defined this condition in 1889.
We experienced a case of a 47-year-old female with two lesions of carcinoma at intervals of seven years. One lesion had been on the gingiva on the right side of the mandible, which had undergone an excision five years before, and the other appeared on the opposite lingual margin, on which chemotherapy and interstitial irradiation were caned out this time. Although both were squamous cell carcinoma histopathologically, the lesions were diagnosed multiple carcinoma from clinical examinations and features.
The purpose of this paper is to present an additional case of multiple carcinoma which might contribute to the etiology of malignant tumors.

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A 2 year-old-girl admitted to our department with a chief complaint of a mass on the tongue base. Resection of the lesion was carried out under a clinical diagnosis of the benign tumor and followed up for 2 years. Pathological examination of the tissue showed the thyroid tissue which is not malignant. A normal thyroid gland was proved to be present in the neck by the CT scan and thyroid scintigram.
Lingual thyroid with cervical thyroid is comparatively rare. Montgomery reported that the lingual thyroid without the cervical thyroid was 65 per cent.
We surveyed 172 cases of the lingual thyroid for the last 87 years in Japan. There was the ratio of 1 to 5 between male and female, female predominated. Age was most in teens. Lingual thyroid with absence of the cervical thyroid gland was 58. 1 per cent.
Thyroid-function tests and the thyroid scintigram are necessary on the posterior dorsal surface tumor of the tongue before treatment.

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A case of herpes zoster involving the fifth cranial nerve is described. Cytosine arabinoside which is an inhibitor of DNA synthesis was used as an antiviral drug. In addition, some immunological examinations were a carried out.
Cytosine arabinoside was thought to be effective and the suppression of cell-medated immunity was suggested in this case.

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A case of pleomorphic adenoma in the cheek of a man aged 68 is reported.
The pleomorphic adenoma was immediately removed surgically.
Histopathological examination showed a duct-like structure and myxomatous variation.
During the observation period of 6-years and 3-months, the patient remained asymptomatic.

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Two patients who had psychogenic reactions in the surgical dental treatment visited our hospital.
One was a 54-year-old married woman and the other was a 34-year-old single woman. Case No.1 was worried for 27 years about her condition stemming from her second delivery, and Case No.2 was worried about exodontia for 14 years.
The psychogenic reactions were chiefly somnolence produced from anxiety caused by local anaesthesia and refusal of all drugs. These conditions were caused by their exposure to old psychogenic traumata and indicated the escape and negative attitudes from the real difficulty of their lives. Generally we call such a condition “conversion hysteria”.
We treated them with psychotherapy which was based upon their self-analysis, and shortly after we cured of their psychogenic reactions.
In these papers, we studied their origins based upon their anxieties.

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It is found that the cure rate of the malignant tumor is improved by using myocutaneous flaps after surgical removal of the mandible and oral floor.
In majority of cases, it was difficult to recover satisfactory functions only by immediate reconstructive surgery.
So we additionally reconstructed masticatory disturbance and difficulty of speech by alveoplasty with full thickness skin grafting from the clavicle region.
Five postalveoplastic patients (4 men, 1 women) ranged from 18 to 67 years old.
All of them did well postopretively and had been followed for 1 year and 7 months without scar contracture and the relapse.

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A granulocytopenia developed in a 19-year-old man who had the surgical operationof resection of the mandibular bone for chronic osteomyelitis. This lesion occurred after daily intravenous administration of cefmenoxime for 21 days. When the serum of the patient was examined immunologically, no specificity to cefmenoxime but cross reactivity to another antibiotics were observed. Steroid therapy and fresh blood transfusion facilitated recovery of the lesion.
Although he received no antibiotics during treatment, the patient had no signs of infection as a result of isolating sterilized condition.

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A 53-year-old woman was seen because of a large defect of the hard palate after tumor surgery. The defect was completely closed with the median large tongue flap.
Free buccal mucosa was grafted to the area of the tongue defect and deformity of the donor was minimal and no functional problems have been found.

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A case of ameloblastic fibroma which is very rare in comparison with ameloblastoma in occurrence was reported.
The patient was a 5 year-old female who visited our hospital because it was noticed during dental inspection that she had an abnormal radiolucent lesion in the right molar region of the mandible. There was slight and diffuse swelling in the right mandibular region extraorally, and a bony expansion in the right molar region intraorally. X-ray examination showed a multilocular radiolucent shadow in the region from C apex to 6 tooth germ. The clinical diagnosis was ameloblastoma. Enucleation was done under general anesthesia. The tumor was a white solid mass with a thick fibrous capsule, and was about 3.0cm in diameter.
Light microscopy showed that the tumor was composed of cellular and fibrous tissue in which there were islands and strands of odontogenic epithelium. The fine fibers were moderately stained with Azan stain and the basement membrane between the odontogenic epithelium and connective tissue was stained with both Azan and Reticulin stains. PAS-Alcian blue stain was negative. Histopathological diagnosis was ameloblastic fibroma. Under the electron microscope, tall columnar cells were observed on the periphery of the epithelial islands and strands, and were connected with each other by well developed desmosomes and gap junctions. These findings were discussed in relation to the stage of amelogenesis.
There was no sign of recurrence at about a year after the operation.

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We have recently experienced a case of lower-face Sparganosis Mansoni.
Sparganosis was first described in 1832 by Mansoni who found the infection in a sailor from Amoy, China.
The most common presentation of Sparganosis is that of a subcutaneous mass or nodule which may be tender. Locations such as the abdominal wall, chest wall, neck and eyelid have been reported in the literature.
A 36-year-old woman visited our hospital with a complaint of painless swelling of the mental region.
Resection of the tumor was performed under general anesthesia. Histopathological finding of the tumor was obtained by a positive skin test using the antigen which was extracted from Diphillo Bothrium Mansoni.

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The nasal deformities associated with primary cleft lip repair appear to involve two major architectural deficits in the cleft side; one is a transformation of the alar cartilage, and the other is a depression of the maxillary segment due to the alveolar cleft.
With regard to rhinoplasty for the cleft lip nasal deformities, reconstruction only for the alar cartilage could not produce a symmetrical shape of the nose, because the maxilla is still depressed which supports the base of the nasal ala.
The present study is intended to utilize the autogenous iliac bone graft to improve maxillary depression in the cleft side of the anterior nasal fossa, prior to reconstructing the alar cartilage form. Four cases with various degrees of cleft lip nasal deformities are demonstrated, and discussion is made how the alar base contour of the cleft side was improved by the bone graft to the alveolar cleft. A case of long-term follow up of 6 years is also presented to show the stability of the grafted bone.

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A 67-year-old female patient came to the Department of Dentistry and Oral Surgery, Nagoya City University Hospital, on February 9, 1976 complaining o swelling in the right cheek. A diagnosis of osteosarcoma was made by biopsy Radiotherapy with 9, 050 rad and necrotomy were done, and the patient has been observed for 8 years and 8 months without signs of recurrence. Cases of osteosarcoma in the maxilla are also discussed in the light of the literature.

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Accidental displacement into soft tissue of the infratemporal space may occur during extraction of the upper third molar. The tooth was not in the corresponding alveolar wound but was roentgenographically located in the posterolateral space of the maxillary tuberculum and under the zygomatic buttress.
By means of an extensive mucosal incision, it was probed with injection needle and could be removed with a gentle grasp by a small hemostatic forceps. There was not seen a breakage of the thin alveolar cortex nor maxillary tuberculum. After a difficult removal, the extraction wound healed uneventful.

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A rare case of mesenchymal chondrosarcoma of the right maxilla of a 46-year-old man was presented.
The patient was treated by preoperative radiation with 3, 500 rad of linac which was uneffective, and then radical resection of the tumor and radical neck dissection were performed. Chemotherapy with high dose methotrexate and leucovorin was employed and was very effective for the recurrence of the intraoral wound one month after the surgical procedure. However, the administration of high dose methotrexate was stopped because of the complication of severe myelosuppression. Finally, he died due to bleeding from the recurrent tumor eight months after his first admission.
Histopathologically, the biopsy specimen revealed numerous variably shaped cartilageous islands separated by sheets of poorly differentiated mesenchymal cell. The chondrocytes in most areas showed enlargement of the nuclei and an open chromatin network.

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A 59-year-old woman, who was indicated an impacted molar about 30 years ago by a dentist, had noticed some swelling and the spontaneous pain of the left submandibular area. X-ray examination showed an impacted second or third molar, the roots of which exposed vertically from the lower border of the mandible. After antibiotics chemotherapy, an operation from the extra-oral approach was performed under general anesthesia. An incision was made on the skin of the neck beneath the mandible about 7cm in length.
The root of this tooth was out of the lower border of the jaw hanging on neurovascular bundle. The tooth was removed carefully. Postoperative course was not eventful. X-ray examination showed good bone regeneration at 1 year after the operation.

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Dentigerous cyst in an infant is rarely reported. The present report demonstrates a case of a 3-year-old boy with bilateral multilocular dentigerous cysts including the 1st molars of the mandible. The cysts were totally extirpated including the involved teeth, because of a persistent infection of the cystic cavities.
During the past 5 years, 299 patients with jaw cysts have been treated at the 1st Department of Oral and Maxillofacial Surgery, Osaka University Dental Hospitals and Clinics. A retrospective study concerning the histopathological diagnosis for those patients showed that 58 cases (19.6%) were diagnosed dentigerous cysts.
The study also indicated that the case reported in this article showed several rare findings for dentigerous cysts, such as that the cysts were manifested in infancy, occurred bilaterally and multilocularily, and included the 1st permanent molars.

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A 24-year-old male consulted our out-patient clinic on October, 1983 because of a round mass in the left upper neck. History of patient illness revealed that he noticed the round mass about the size of a thumb tip, with low grade fever and sweating about a month prior to consultation.
He had taken medication for one week but without benefit. He was thin, fairy nourished and no weight loss for the last 6 months. Past medical history and familly history were unremarkable.
On clinical examination, the round mass in the upper neck was 6.5 cm in diameter and another round mass, the size of a pea was noticed in the posterior cervical triangle. The mass was elastic, movable and not tender to palpation. There was no lymphoadenopathy in the contra-lateral neck, both sides of the supraclavicle fossa, axilla and inguinal region and no hepato-lienomegaly was observed.
Laboratory findings revealed slight anemia, leucocytosis, decreased number of lymphocyte, CRP 1+ and fairy high level of ESR. Although the tuberculin test gave a positive result, chest X-ray was normal. Many physical examinations were performed and didn't allay the suspicion of the malignant lymphoma, so a biopsy was done. Histopathological results showed Hodgkin cells (H cell), Reed-Sternberg cells (R-S cell), diffusely developed lymphocytes, eosinophils and large monocytes. A part of specimen showed a few of necrosis and fibrosis. The diagnosis was Hodgkin's disease of the mixed cellularity type. Clinical stage was IVb because of the presence of H cells and R-S cells in cytologic examination from the aspirated bone marrow and B-symptom because of fever and sweating prior to consultation.
Therapy was performed as follows: combination chemotherapy (COPP) and irradiation (mantle field) and in addition another combination chemotherapy (ABVD). He was discharged July, 1984 and is being followed up in the out-patient clinic.

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Lipoma in the tongue is considered rare. Besides, lipoma which has appeared bilaterally in the tongue margin is reported only in nine cases in Japan. Authors reported a case of lipoma in the bilateral tongue margin noted in 69-year-old male.

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The pleomorphic adenoma developing in the palate of a 44-year-old man was examined by scanning and transmission electron microscope.
The results obtained were as follows: By scanning electron microscopy; the tumor consisted of columnar or cuboidal cells of one to two layers which formed lumens of various sizes and shapes, the short stubby microvilli protruded into the lumen of ducts from the surface of each cells and the ducts were densely surrounded by the fibrous connective tissue.
Development of organelles in the cytoplasm which had many secretory vesicles was observed by transmission electron microscopy.
From the morphological point of view, the cells of pleomorphic adenoma developing in the human palate region should be considered to be of epithelial origin.
Now it is doing well and it has no tendency to recur or change for the worse.

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Herpes Zoster is the viral disease of skin and mucosa characterized by grouped vesicular eruptions along a peripheral nerve, and it is thought that cell-mediated immunoactivity is involved. A case of Herpes Zoster in the right region along the second trigeminal nerve branch of a 58-year-old male was reported. The relation between clinical behavior and serum immunological examination was studied. The results were as follows:
1. A possible decrease of cell-mediated immunoactivity in the serum examination at the initial stage of the disease.
2. The comlement fixation test (CF test) is dependable as a differential diagnostic procedure for Herpes Zoster.
3. Close relations between complement system, antibody titer and clinical behaviors.

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Acute necrotizing ulcerative gingivitis (ANUG), also known as noma or gangrenous stomatitis, is a markedly progressive and destructive disease of the oral and facial tissues that generally occurs in debilitated individuals. However with the advent of antibiotics and the development of public health the incidence has gone down but ANUG has yet been seen with special reference to systemic diseases.
We recently experienced a case of ANUG in a transfusion-associated hepatitis patient and described it in this paper.

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Nasoalveolar cyst are considered rare. As their names implies, these structures are found in a borderline area where they may be seen by otolaryngologists. A 42-year-old woman was referred to our hospital, because of a swelling and tender lesion in the nasal vestibule. It expended anteriorly causing elevation of the nasal ala. Plain radiogram by an occlusal film showed slight thinning in the 2nd and 3rd upper incisor tooth region. The contrast radiogram, in which 60% urografin was introduced as the contrast medium, revealed a 3×2cm oval radiopaque shadow in the maxilla at the nasoalveolar region. The radiopaque shadow had no relation to the teeth and the maxillary antrum.
About 3ml of yellowish serous fluid was aspirated by puncturing.
The lesion was diagnosed a nasoalveolar cyst. The entire lesion was enucleated by surgery from the patient under local anesthesia. The lesion appeared to be surrounded by the connective tissue.
Microscopic examination of the sections in the surgical specimen disclosed a cystic cavity lined with the ciliated columnar epithelium approximately three to five cell layers thick.

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We experienced a case of postoperative myocardial infarction in a 55-year-old female who didn't suffer any cardiovascular disease before the operation. This patient has developed a cancer of the right mandible. After radiation and chemotherapy (Pepleomycin) the patient was treated with surgery. The attack of chest pain developed 6.5 hours after operation (partial mandiblectomy, suprahyoidal neck dissection and right deltopectoral flap transplantation) under general anesthesia (GOF). The ECG tracings soon after the attack suggested myocardial infarction of the anterior-lateral wall. The patient was treated by Ca-antagonists, Nitroglycerin and Lidocaine at rest. The patient's progress toward recovery was satisfactory. 28 days after the first operation the secondary operation (separation of flap) was made in local anesthesia after premedication with atropine and morphine with success. From the series of ECG changes for 6 months, it was diagnosed to be acute reversible myocardial infarction followed by subendocardial infarction.

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Precancerous melanosis, that Hutchinson first described as senile freckle and later Miescher termed melanotische Präcancerose, is rare in the oral cavity. We have reported precancerous melanosis on the palate. A 68-year-old woman visited our clinic with a main complaint of pigmented spots in the palate. We saw blackbrown spots in the hard palate and soft palate within 19×22mm areas. Their surface was smooth and had no swelling.
Clinical diagnosis was suspected malignant melanoma. We excised the mucosa of the palate far over 2cm areas from the border of the spots. Histological findings showed melanocytes had proliferated in the basal cell layers and the deformation of some nucleus of these cells was seen. Pathological diagnosis was pracancerous melanosis. We dose with anticancer agent and immune therapy agent during seven and a half months after operation. Two years and three months have passed and the prognosis is favorable with no reccurrence.

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Oral symptoms constitute one of the greatest sources of discomfort and potential danger in leukemia. Oral infection continues to be the leading cause of morbidity and mortality in patients with acute myeloblastic leukemia. The oral complication induced by inflammation gives the patients anguish. Further more, oral complication in patients who have undergone immunosuppressive and myelosuppressive treatment is reinforced. It is therefore crucial to eliminate oral sources of potential infection in these patients; toothbrushing, flossing and extractions (oral management) could be means of achieving this goal. Five cases involving the oral management of patients with acute leukemia (AML) are described. In all cases dental extraction (14 teeth) were performed (platelet; 1, 000-28, 000/mm³, leukocyte; 700-3, 800/mm³.). In one case pulpectomy (5 teeth) and in another cases plaque control (brushing and flossing) were performed.
The avoidence of dental extraction in these patients has generally been recommended.
However we feel that surgical procedures may be performed on patients with controlled disease and adequate management. No hemorrhagic complications occurred in any patients, and the temporary infection was managed with systemic antibiotics and oral irrigation.
The patients were carefully instructed in plaque control with the use of a tooth brush and dental floss and subgingival scaling.
Oral environment in all cases was improved. Because of the difficulty in treating oraldisease in leukemic persons while they are undergoing chemotherapy, it is extremely important that such patients have dental evaluations and, if possible, treatment prior to initiation of medical management for their neoplasia.

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Amongst the various types of tumors found in the salivary glands, pleomorphic adenoma showed highest incidence and is said to account for 60-70% of tumors developing in the major salivary glands.
Its incidence is particularly high in the parotid gland, followed by the submaxillary gland and lesser salivary glands, in decreasing order. Conversely, cases of growth in the sublingual gland are rare, and detailed reports of these cases in Japan are seldom encountered in the literature.
In this paper, we wish to briefly report the case of a 60 year old male with pleomorphic adenoma growth in the sublingual gland.
The patient visited a local clinic for caries treatment when a tumor was discovered in the sinistral oral floor. He was introduced to our department for treatment and first visited on June 4, 1982.
Examination revealed a tumor with smooth and glossy surface and distinct margins the size of a thumb, along the sublingual fold of the sinistral oral floor.
The size of the enucleated tumor was 2.0×2.0×3.0cm. It was soft and resilient, and a cross section revealed greyish-yellow tremelloid contents with chondroid material in some areas. Histopathologically, it was diagnosed pleomorphic adenoma.
Two and a half years have elapsed since the operation and although the patient is showing good progress, we feel the necessity for further long term observation since this particular tumor is known to possess recurrence tendencies.

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A rare case of an acute odontogenic sinusitis resulted in exophthalmos of a 43-yearold man was reported. Following curettage of the 7 periodontal pocket, an acute sinusitis involved the right orbit, and unilateral exophthalmos developed thereafter. CT-scanning demonstrated the inflammatory change in the right side of maxillary and ethmoid sinus and orbit. Exophthalmos disappeared within 2 weeks after administration of antibiotics and extraction of the tooth.

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Metastatic tumor of the oral cavities in children are extremely rare. However, the sarcoma occuring in a child which will have hematogene distant metastasis is not so rare and may indicate metastasis of the oral cavity.
This paper presents a case of probably metastatic Ewin's sarcoma to the mandible from the left shin bone in a boy of nineteen years old. It also demonstrates metastases to the bilateral lungs, the right shoulder blade and both thigh bones.
Ewing's sarcoma usually shows high radiosensitivity. However, it is highly malignant tumor with spreadable metastases and the prognosis is very poor. This case also showed the bad outcome that was followed by spreading metastases and finally death four months after discovery of the metastatic mandibular tumor.

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The Johanson-Blizzard syndrome is considered to be a syndrome characterized by congenital aplasia nasi, deafness, hypothyroidism, drawfism, absent permanent teeth and malabsorption.
The patient is a female, age six years and ten months, born of parents who are cousins and thinner addicts.
The facial and oral signs and symptoms were as follows: The panorama roentgenogram revealed missing teeth except the following. The upper and lower first molars including the roots of the lower first molars were taurodont. The lower right first and second deciduous molars, the lower left deciduous canine and first left deciduous molar were microdontic. The maxillary dental arch was smaller than the mandible. The philitrum and the Cupid arch of the upper lip were not apparent.
Because of the caries and occlusion improvement, the authors carried out extraction of the deciduous teeth stumps, and placed amalgam fillings in the lower right first and second deciduous molars and the lower left first molar under general anesthesia. After extraction dentures were put in, the lower denture did not come up to expectations. Hypocalcified layers were scattered in cementum of removed deciduous tooth on microscopical observation.
This case seems to be the first report of the Johanson-Blizzard syndrome related to oral surgery in Japan.

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We studied the speech disorders resulting from the congenital muscular macroglossia and its healing process, especially with regard to the articulation disorders, through the investigation before and after operations that were held twice with the intention of reducing the tongue volume. The results were as follows:
1. Dentals and alveolars showed the severe articulation disorders, as well as milder ones of velars, bilabials and vowel /o/.
2. Though the lips were not used for the occasion of articulating bilabials because of the macroglossia, bilabials showed mild articulation disorders. The reason was considered that the dorsum of the tongue and the upper lip compensated the function of the lips. Soon after the first operation, contact between the upper and lower lips became possible, but the articulation disorders of bilabials increased, because of insufficient exercise of the lips for articulatin of bilabials.
3. The last remained articulation disorders were perceived in alveolars /r, rj/. but these sounds were improved within six months after the second operation.

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Follicular cysts are often associated with unerupted teeth. These cysts are derived from the enamel organ of the developing tooth and may be formed at different stages of the development of tooth. It usually appears in patients below the age of 20 years and unusually above the age of 50 years.
We have found by chance a large follicular cyst in a 74-year-old male. He was overturned in a bus and ther suffered facial swelling and difficulty in opening his mouth. He was referred to our clinic. A fracture was found on the right mandibular ramus and a large follicular cyst was located on the right mandibular ramus extending toward the same side canine region.
We enucleated the cystic epitherial lining, and extracted the unerupted tooth. The large cavity was packed with gauze. Because of mild fractrue displacement, he was treated by neither reduction nor fixation.
Postoperative healing was uneventful, and the pack was finally removed on the 30 th postoperative day. Now nine months have passed, and the cavity is almost closed and there are no signs of recurrence.

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Three terminal-stage oral cancer patients received intravenous micro-drip administration of ketamine (Ketalar^®) for pain management.
A combination of diazepam with ketamine was administered to the patients to prevent the side effects of ketamine such as hallucination, excitation and dementia, and analgesic and sedative effects were observed.
Two patients safely received long-term administration of ketamine, however ketamine was stopped in one patient because of side effects.
This approach suggests that combination use of ketamine and diazepam is useful for the relief of cancer pain.

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Two cases of metastatic tumors of the mandible are reported.
The first case, a 61-year-old male, was large cell carcinoma in the lung metastasized to the left mandible.
The second case, a 75-year-old male, had papillary tubular adenocarcinoma in the stomach metastasized to the left mandible. In this case, metastatic and primary carcinoma were found at the same time in one oral region. Histologically, metastatic tumor of the mandible was papillary tubular adenocarcinoma from the stomach and primary tumor of the maxilla was squamous cell carcinoma arising from maxillary sinus respectively. Metastatic tumor of the mandible was detected 8 years after gastrectomy. For these reasons, this case was especially rare and unusual.

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A case of von Recklinghausen's disease with oral manifestation was presented with review of literature.
The patient, a 46-year-old male, showed skin tumors and pigmentation on the trunk, face and extremities, and oral manifestation on the mandibular gingiva.
Deformation due to facial skeltal hypoplasia was observed at the right angle of mandible.
Hereditary factors were suggested in the family history.
After surgical excision of the oral cavity tumors, the patient progressed satisfactory without recurrence.
In the histologic findings, the tumors both in the gingiva and the skin were diagnosed neurofibroma.

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Two cases of adenomatoid odontogenic tumors are presented.Case 1 was a 15-yearold girl and case 2 was a 13-year-old boy.
Radiographic findings of these two cases showed a large well circumscribed radiolucency involving the impacted teeth (case 1: right mental region of mandible, case 2: left mental region of mandible). Many small irregular radiopacities scattered along the pericoronal area were also noted in case 1 and this was thought to be a characteristic radiographic findings of the tumor.
Both of these two cases showed typical histopathological findings of adenomatoid odontogenic tumor.

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