Mitogenic responses and lymphokine productions of spleen cells of C3H/He mice in mixed culture with syngeneic tumor cells (mixed lymphocyte tumor cell culture, SMLTC) were studied. Spleen cells of C3H/He mice showed a mitogenic response to X5563, MH134 and MM48, syngeneic tumor cells expressing major class I histocompatible antigen (MHC), but not to MM46 without an expression of either class I or class II antigen. Mitogenic responses to these syngeneic tumor cells could be observed on day 1 and peaked on day 3. Accompanying this mitogenic response, an activity to induce proliferation of FDC-P 2 cells, a responder for interleukin 3 (IL-3), was detected in the SMLTC fluids. Interleukin 2 (IL-2) nor interferon (IFN) activities were not found in the culture fluids throughout the 2 weeks observation period. The chromatography on FPLC MonoQ column of the condensed SMLTC culture fluids revealed that the proliferative activity against FDC-P 2 was eluted from the column with the same pattern as those of IL-3 found in the culture fluids of WEHI-3 and EL-4 cells. Neither IL-2 nor IFN activity was found in the condensed SMLTC supernatants and their effluents from MonoQ column.
Next, generation of cytotoxic effector cells against a stimulator cell line and an activity of natural killer (NK) cells in each SMLTC system were examined. The results showed that both cytotoxic activities, of which the generation required IL-2 and IFN, could not be found. In the SMLTC system, in which IL-3 production could be observed, a cytotoxic activity against MethA cells, a target for natural cytotoxic (NC) cells, was induced. These results indicate that tumor cells in interaction with syngeneic spleen cells induce mitogenic responses and produce IL-3 and IL-3-dependent nonspecific NC-like cells, but not IL-2 and IL-2 dependent their cytotoxic T cells and NK cells.

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4-nitroquinoline 1-oxide added to drinking water at three concentrations (10ppm, 25ppm, 50ppm) was administered to 45 male S-D strain rats for 7 months. Major findings were as follows.
1) Squamous cell carcinomas appeared earlier in 25ppm and 50ppm groups as compared to 10ppm group.
2) The carcinomas were most frequently observed in 50ppm group with highest incidence of infiltrating tumor as well.
3) Ulcerating carcinomas more frequently appeared in higher concentration groups.
4) The historogical type of carcinoma was almost identical in all groups examined.
5) No metastasis was observed in any treatment groups examined.
6) No malignant neoplasma was observed in any other organs except for oral cavity.

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The influence of hematoporphyrin derivative (HpD) and photoradiation on eight culture cells of oral cavity and jaw in origin was studied.
HpD activated by photoradiation showed a cytocidal effect on not only culture cells derived from squamous cell carcinoma but also cultured fibroblast.

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Amyloidosis is a disease characterized by the intercellular deposition of amyloid fibrils in various tissues and organs. The eitology and treatment method are unknown in spite of many studies.
A case of primary amyloidosis is reported. The patient was a 54-year-old woman who complained of tumor formation at the soft plate. She had been followed by the department of internal medicine for about two years. Various organs in her oral cavity were getting involved for the past year.
Light and electron microscopic studies were caned out on tissues excised from the tumor of the soft plate and tongue. An eosinophilic amorphous substance was seen by light microscopically, throughout the subepithelium. Electron microscopically, felt-like appearance of amyloid fibrils was clearly seen and the fibrils varied 80 to 100 A in width. Cells embedded in the fibrils showed various changes on the cell membranes and cytoplasms.

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Surgical augmentation for atrophic redidual ridge is one of the ultimate preprosthetic procedures facilitating an “ideal” denture construction.
In this paper, we present a 50-year-old female treated with surgical ridge augmentation of both jaws, who worried about excessive denture mobility. We apllied Le Fort I osteotomy with interpositional bone grafting and vestibuloplasty to maxilla. During 2 years following the operation minimal positional change of bone segment and alveolar resorption occured. In mandible, modified Härle's visor osteotomy and inferior (submental) border bone grafting in combination with vestibuloplasty using skin graft were adopted. The results were very stable the first 6 months after augmentation, but from 6 months to 2 years posterior alveolar ridges improved by visor osteotomy relapsed to pre-operative level and anterior vertical height increased by inferior border bone graft was reduced to 62 percent. Now the patient is almost satisfied with acceptable dentures without any surgical complications such as TMJ problems or neural damage.

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Therapeutic results in our 31 patients with squamous cell carcinoma of the tongue during the past 9 years from 1975 to 1983 were as follows:
The accumulated 5-year survival rate was 61.4% in 6 cases of chemotherapy+ radiotherapy group which was inferior to 70.7% in 23 cases of chemotherapy+ radiotherapy+ surgical intervention. The overall 5-year survival rate of 31 cases in total was 66.1%. According to the stage of disease, it was 78.8% in Stages I+ II group which was distinctly superior to 42% in Stages I+ IV group. The 2-year suppression rate of primary lesion was favorably higher in chemotherapy+ radiotherapy group (87.5%) than that in chemotherapy+ radiotherapy+ surgical intervention group (69.2%). The 2-year survival rate in cases of metastasis of the cervical lymph node at the first examination was low as 25%, while that in cases of cervical metastasis after treatment was relatively high as 66.7%. In addition, the 2-year survival rate was most superior as 88.9% in cases without cervical metastasis (negative cases) throughout the study period. The cause of death encountered in 9 cases included: 1) relapse of primary lesion in 2 cases (T₃ and T₄ respectively), 2) metastasis of the cervical lymph node in 4 cases (each 1 case of Stages I and II, 2 cases of Stage II), 3) metastasis of the lung in 3 cases (1 case of Stage I and 2 cases of Stage iv).
For local suppression in T₁ and T₂ cases, a sufficient therapeutic effect could be expected only with chemotherapy+ radiotherapy. However, an increased cervical metastasis tended to be observed probably due to increased dose of irradiation. On the contrary, less cervical metastasis was observed in cases undergone chemotherapy and radiotherapy followed by partial resection probably due to lower irradiation dose employed, resulted in superior clinical results. In cases of T₃ and T₄, on the other hand, a combined therapy including chemotherapy, radiotherapy, radical neck dissection and reconstruction was considered to be expectable for enhancing its therapeutic result.

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A modified method of Koele's technique reported in 1983 was applied to four cases of temporomandibular habitual luxation, while changes in the transplanted tissue with clinically used lyophilised dura (LYODURA) were observed in experimental animals. These results are summarised below.
The modified procedure in brief is as follows. Formation of pedicle flap of dermis at the preaurecular region was almost same as the original method, however, the flap was strengthened with LYODURA. The dermic flap combined with LYODURA was introduced through the mandibular incision into the oral cavity. Both the flap and LYODURA were tightly sutured at the lateral portion of the coronoid process, i. e. to the lateral pterygoid muscle attachment for suppresing mandibular movements. The lower jaw was immobilized for about 3 weeks after surgery. This operation led to good results in four cases of habitual luxation of the mandible.
Histologically, no foregin body reaction to grafted LYODURA was seen in dogs, and the planted LYODURA normally existed. From these clinical and experimental results, this surgical approach with potent LYODURA seemed to be applicable for treating temporomandibular habitual luxation.

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We studied articulating and mobilizing processes of the tongue in patients with congenital muscular ankyloglossia accompanying servere articulation disturbance before and after myotomy for mobilization.
Results
1. All vowels/a, i, u, e, o/showed slight otosis before operation, which however completely disappeared after operation.
2. Many consonants /k, g, kj, gj, dz, r, rj/preominantly showed a tendency of otosis before operation but favorable articulating function and tongue mobilization were recovered after operation except for /r/and /rj/.
3. Unfavorable tongue movements still remained as for /r/and /rj/consonants even after operation, resulted in a tendency of otosis.

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A case of pyostomatitis vegetans associated with ulcerative colitis of a 22-year old woman has been reported, and clinical appearances, etiology and immunological mechanisms of development were discussed. Ulcerative colitis, as well as Crolm's disease and proctitis, is one of the inflammatory bowel diseases which have many local and systemic complications. Oral manifestations of ulcerative colitis arc as follows; 1) recurrent aphthous ulceration, 2) pyostomatitis vegetans, 3) ulcers analogous to pyoderma gangrenosum of the skin and 4) hemorrhagic ulcers of the oral mucosa and skin.
The present case showed clinical appearances of above pyostomatitis vegetans, indicating numerous small papillary projections that contained miliary abscesses occurring in an area of intense erythema on the gingiva. The mucosa had been thrown into folds along gingivobuccal sulucus. Bacteriologic studies revealed no specific findings except normal oral microorganisms. Little subjective discomfort was associated with this condition. The histopathologic appearances were also compatible with pyostomatitis vegetans in which acanthosis and hyperkeratosis could be seen with elongation of the rete pegs. Small pustules existed in and under the epithelium of papillary projections. A dense lymphocytic and plasms cellular infiltration was found in the lamina propria, and cellular infiltration was reconfirmed by direct immunofluorescence technique using antihuman IgA antibodies, etc.
The oral manifestation became worse and regressed according to the conditions of recurrence and covalescence of ulcerative colitis. The lesion responded well to topical application of a gluco-corticoid steroid hormone.
The present case indicates that, in findings this kind of lesion on the oral mucosa, a possibility of gastrointestinal disturbance due to inflammatory bowel disease should be considered.

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Some large cavernous hemangiomas of the tongue were removed by hollowing-out approach using CO₂ laser beams. The operative procedure was proved to have the following merits:
1. shortened operation time,
2. decreased blood loss,
3. maintained shape and mobility of the tongue, and
4. preserved tongue senses including taste, pain and so on.

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A 61-year-old man who had squamous cell carcinoma originating in the mouth floor was treated with radiation therapy and radical surgery. About one year after the operation, the tumor metastasized to the neck lymphnode. The excised node represented histopathologically “adenosquamous carcinoma”. Then, chemotherapy with 5-FU (total 6000 mg i.v.) was employed. At present, recurrence has not been observed after the therapy. Retrospectively, the original squamous cell carcinoma was examined histochemically, and it revealed a little intracytoplasmic mucin.

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A 20-year 3-month man who suffered severe asymmetry in the middle and lower third of face was presented. Simultaneous mobilization of maxilla and mandible (Le Fort-I Osteotomy+ Sagittal Splitting Osteotomy) was performed to flatten occlusal plane and after 6 months Genioplasty was done to correct remaining facial asymmetry.
Although minimum skeletal relapse occurred quite early after the first operation, desired facial symmetry was acquired.

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A case of a fresh open comminuted maxillofacial fracture is presented.
This 38 year-old male, who was on a motor cycle and struck in the left side of the face by a parking car on April 12, 1982 was trasferred to an emergency service of our hospital on the following day with a diagnosis of fractures of the fibula and the pelvis, and face laceration. Physical examination on admission disclosed that his consciousness was clear. There was a laceration in the left cheek through which the maxillry sinus was open.
A comminuted fracture of the maxilla with a longitudinal fracture of the palate and 2-6 alveolar bone fracture were revealed by X-ray and CT scan. Fracture of the fibula and the pelvis were treated nonoperatively. An open reduction for this maxillofacial fracture was immediately performed under a general endotracheal anesthesia. The main purpose of this operation was functional correction of occlusion. Bone fragments were brought into the occlusion and intermaxillary fixation with splints was performed. A radical operation of the maxillary sinus was subsequently carried out through the cheek laceration. A drain was placed through the nasal cavity. Intermaxillary fixation was continued for 50 days postoperatively.
The patient obtained a normal occlusion. He is quite satisfied cosmetically as well as functionally.
When managing a trauma patient with a maxillofacial injury, the functional reduction of the maxillofacial fracture should be considered soon after life support care.
The difficulty in a quick assessment for the minimum requirement in the treatment of the maxillofacial injury among other priorities was summarized.

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The changes in the position of the temporomandibular joint after orthognathic surgery were examined by estimating the condylar angulation in the transverse plane. The condylar angulation was measured using xeroradiography obtained from submentovertical projection. 6 cases of sagittal splitting ramus osteotomy and 3 cases of Le Fort I osteotomy were enrolled in this study.
The results obtained were as follows.
1) The condylar angulation in patients received sagittal splitting ramus osteotomy increased significantly soon after operation and then showed a tendency to gradually decrease with time.
2) Among cases of sagittal splitting ramus osteotomy, the condylar angulation in 2 cases which had a large difference between right and left movementas of the mandibula decreased at the side of larger movement.
3) The condylar angulation in cases of Le Fort I osteotomy should almost no change after operation.
From these results, it was suggested that a monitoring of the condylar angulation after orthognathic surgery are very useful for evaluating the postoperative course.

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Verruciform xanthoma occurring at the border of the hard-soft palate in a 58-yearold female is presented. It is a rare lesion of the oral cavity which usually has a warty or papillary appearance. In 1971 Shafer first described in details its clinical and histopathological features. In Japan the first case was reported by Kikuchi et al. in 1977. Since then twenty cases have been reported.
This article reports one case of Verruciform xanthoma, itslight and electron microscopic findings together with some considerations on literatures concerned in Japan.

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Haemophilia A is a bleeding disorder that usually seen in males and is inherited as a sex-linked recessive trait. The disorder has been reported in females in several families with male haemophiliacs. However about 20% of female haemophiliacs are described as sporadic type.
On the other hand, resently a synthetic vasopressin DDAVP (1-deamino-8-D-arginine vasopressin) was used for haemostatic control of haemophiliacs. The haemostatic mechanism of DDAVP in haemophilia A and von Willebrand's disease is understandable because of the increment of factor VII activity.
Scaling was performed in a female haemophilia A (VII: C 7%) and then DDAVP (0.4 μg/kg) was administered for haemostatic treatment. DDAVP infusion (iv) induced the increment of factor VII activity. This procedure resulted in effective haemostasis without factor VII replacement therapy.

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The adenomatoid odontogenic tumor is a very rare epithelial odontogenic neoplasm. This lesion occurs most frequently in the second decade of life and affects females more frequently than males. This tumor tends to appear more often in the maxilla than the mandible, and the anterior portion of the jaw is the most common site.
This report deals with the detailed description of a case of adenomatoid odontogenic tumor in the mandible of a 16-year-old female.

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Benign osteoblastoma is an uncommon benign bone neoplasm. It was described independently but about same time in 1956 by Jaffe and Lichtenstein. The most frequently affected sites are the vertebrae and the long bones, but rarely jaw bones.
We experienced a large benign osteoblastoma in the left mandible of a six year old female. Radiographs showed the tumor extended from the right second deciduous tooth area to the left first molar area. Hemimandiblectomy was selected as the most suitable treatment and the operation was performed successfully under hypotensive general anesthesia without blood transfusion, because the parents of the patient were Jehovah's Witnesses and persistently rejected blood transfusion. On the basis of this experience, the discussion of the medico-legal problems in the management of Jehovah's Witness patients was added in this paper.

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A case of nonossifying fibroma rarely found in the mandible is reported and the literature was reviewed. The patient was a 28-year-old man who had noticed slight pain and swelling in the left side of the mandible about six months before the first examination. The localized hard mass had been growning in size gradually. Radiographic examination revealed a dental crown-sized, ovoid, and well-demarcated radiolucent area in the lower border of the left mandible, with a feature of thin bulging of its bony cortex. Histopathologically, the specimen shows a presence of spindle-shaped fibroblasts and multinucleated giant cells in the swirling appearance of the fibrous connective tissue stroma, and there are no sign of bone formation.

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A rare case of central cemento-ossifying fibroma of the mandibular medial region in a 38-year-old female was present. The histopathological examination showed that tumor consisted of fibrous connective tissue, containing cementicle-like tissues, woven and lamellar bones, and osteoid tissues. The literatures on cemento-ossifying fibroma were reviewed. Futhermore, both clinical and histopathological differences of several fibro-osseous lesions were also discussed.

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Carcinoma of the parotid gland with extracapsular extension and recurrent carcinoma of the gland, which is frequently much more advanced than is clinically discernible, are most difficult and challenging problems to treat.
Four patients underwent aggressive radical surgery to achieve adequate margins. In addition to radical parotidectomy and neck dissection, surgery included resection of the masseter muscle, medial and lateral pterygoid muscles, temporal muscle, skin, mandible, temporal bone and other involved structures such as parapharyngeal space.
In this series, one tumor was previously untreated and the remaining 3 were recurrent after initial surgery. Histologic type of the tumors was carcinoma in pleomorphic adenoma in 2 patients, adenoid cystic carcinoma in 1, and high-grade mucoepidermoid carcinoma in 1. Two of the recurrent tumors had become more highly malignant than the initial tumors.
Histopathologically skin overlying the parotid gland was involved in 2 patients, masticatory muscles in 3, capsule of the temporomandibular joint in 1 and parapharyngeal space in 1. No bony involvement was revealed in the surgical specimens. These histologic findings were satisfactorily correspondent to those of the preoperative CT scan. Nodal involvement of the tumor was histologically confirmed in 3 patients, and metastatic nodes spread in the deep jugular chain from the base of the skull to the middle jugular portion and the spinal accessory chain. In addition to the direct extension of the primary tumor, these nodal findings demanded the dissection of the parapharyngeal space in conjunction with the resection of ascending ramus of the mandible.
Three of 4 radically parotidectomized patients were alive with no evidence of disease from 6 to 28 months postoperatively. One patients died of local recurrence 29 months after the operation.

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A number of actinomycotic infections of maxillofacial region as specific inflammation have been reported. However, recent development and application of antibiotics have sometimes caused difficulty in the differential diagnoses and early decision of treatment because of resulted difficult demonstration of ray fungus or sulfur granule in the pus.
Recently, the authors found a case of actinomycotic infection which showed pathological bone absorption from mandibular angle to notch region. We applied a combination therapy of antibiotics with radiation.
After sedative treatment, continuous mandible resection and ceramic bone transplantation were done. During operation, rami buccales of the facial nerve cannot help being amputated due to partial necrosis in masseter muscle.
Since many aesthetic and functional disturbances like Bell's syndrome and muscle paralysis of buccal and orbicularis oris had occured following the operation, a dynamic control operation was performed to prevent these sequelae as far as possible, and a rather satisfactory result was obtained.

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A clinical evaluation of corticotomy by Köle's method for presurgical orthodontic treatment was made in 18 patients with jaw deformities. The following results were obtained;
1) Procedure of the corticotomy could be done easily without damage to the teeth. Critical complications such as teeth injury, dental pulp necrosis, root apex absorption, and periodontal lesions were not observed postoperatively. Vital response of the dental pulp was temporarily lost, but recovered after 27 days on the average. The disappearance of the osteotomy line due to corticotomy was observed at about 4 months postoperatively.
2) Corticotomy was found to be a significant procedure for the presurgical orthodontic treatment in adult patients with various socioeconomical conditions because of marked shortening of orthodontic treatment period.
3) Tooth movement for various purposes was certainly obtained in a short time, and this procedure is also considered valuable for general orthodontics.

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In the field of oral surgery, tube feeding is frequently employed for nutritional control, and natural foods or enteral nutrients containing lactose have been the most common form of diet in this system. However, there is a drawback in using enteral nutritional products in that they have side effects which can be serious including putrefaction, diarrhea, vomiting and abdominal distension. Enteral nutritional products are thus unsuitable for long-term enteral hyperalimentation.
A clinical application of Clinimeal ^® was performed in 25 oral surgery patients. Clinimeal^®, given at a rate of 100 kcal/hr with a concentration of 1 kcal/ml, was well tolerated up to a maximum dose of 1, 600-2, 400 kcal/day; This control system helped patients stay in good nutritional condition. Occasional diarrhea was observed in 8 of the 25 patients (32%), but none of them had to be discontinued dosing.
We conclude from these evidences above that Clinimeal ^® is useful for enteral hyperali-mentation and appropriate as usual enteral nutritional products.

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