Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 33, Issue 7
Displaying 1-23 of 23 articles from this issue
  • Degenerative changes and repair of the chondrocyte
    Satoru SHIOTA, Satoshi NAKAMURA, Toru YOSHIDA, Choichiro FUNAMOTO, Kaz ...
    1987 Volume 33 Issue 7 Pages 1275-1280
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The experiment reported in this paper was designed to clarify degenerative changes and repair of the proliferation and differentiation of the condylar chondrocytes by causing osteolathyrism experimentally.
    Experimental methods: Growing 4-week-old male Wistar rats were experimental animals.
    In order to produce the experimental osteolathyrism, 2% aminoacetonitrile (AAN) in physiological saline solution was injected in rats at a dose level of 20mg/100g body weight, intraperitoneally. The AAN administration was performed four with methods; only 1time, 2 times, 4 times and 7 times a week. From these administered methods, the experimental rats were divided into three groups: control, AAN administered and 1 week after AAN administration.
    After the end of treatment, all experimental rats in each group were sacrificed and examined for histopathological findings.
    Experimental results: The 4-week-old rats in the control group had active growth, active proliferation and differentiation of the mandibular cartilage-cells. On the other hand, the characteristic changes of osteolathyrism were observed in the AAN administered group.
    The AAN administered rats of 4 times and 7 times a week showed loss of appetite and depression of gained body weight, etc. in general condition. In the condylar cartilage, a decrease in the fibroblasts, a decrease in chondrocytes and disordered differentiation of the chondrocytes were observed. In addition, AAN administered rats of 7 times a week showed a disturbance of the endochondral bone formation.
    In the “1-week after AAN administration” group, repair of the condylar cartilage, which had active proliferation of the fibroblasts and normally differentiation of the chondrocytes were observed.
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  • Masayuki AZUMA, Hitoshi KAWAMATA, Hideo YOSHIDA, Tetsuo YANAGAWA, Yosh ...
    1987 Volume 33 Issue 7 Pages 1281-1287
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The expression of ras oncogene p21 (p21ras) in the biopsy or operation materials derived from 34 oral squamous cell carcinomas, 33 oral leukoplakias and 10 normal oral mucosae was investigated by the avidin-biotin-peroxidase complex (ABC) method described by Hsu et al. In the current study, the sheep antiserum raised against RasHa p21 and rat monoclonal antibody to p21ras, Y 13-259, were used. The expression of p21ras was found in 17 cases of the 34 oral squamous cell carcinomas examined although all of the examined oral leukoplakias and normal oral mucosae did not show positive staining for p21ras. When the expression of p21ras in oral squamous cell carcinomas was related to clinical tumor status and prognosis, 10 of the 17 cases showing positive staining for p21ras had poor prognosis. The cases with the tumor containing p21ras had significantly poor prognosis compared with cases without p21ras (p<0.005). Moreover, in the cases with the tumor classified grade III according to the classification system of squamous cell carcinoma proposed by WHO, the expression of p21ras was intimately associated with poor prognosis.
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  • Especially collagenous varies and histopathological changes by Bleomycin and its analogues
    Kazuhiko TSUCHIDA
    1987 Volume 33 Issue 7 Pages 1288-1307
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Because of the adverse effects caused by the general administration of anti-tumor drugs, the administration of these drugs often should be stopped or not undertaken before sufficient anti-tumor effect can be obtained. The pulmonary toxicity of Bleomycin (BLM), which is often used in the field of oral surgery and shows excellent effects on squamous cell carcinoma, has been widely known to be a limiting factor in its administration.
    The present study was panned to investigate the disorder and fibrosis of the oral organs as the parameter of BLM pulmonary toxicity. The study was executed fundamentally and clinically. In the fundamental study series, validity of the experimental pulmonary fibrosis model in mice BLM and Peplomycin (PEP), was evaluated biochemically and histopathologically from the viewpoint of fibrosis of oral tissues.
    Results indicated that in oral tissues the change in the parotid gland adequately corresponds to the pulmonary change and that the biochemical parameter also varied according to the histopatohological change.
    In the clinical study we investigated 20 autopical cases: 6 non-cancerous and 14 cancerous patients receiving anti-tumor drugs: Materials were investigated in the same manner as in the fundamental study.
    Results indicated that in the case receiving BLM and PEP, the change in the submandibular gland adequately corresponds to pulmonary change and that the biochemical parameter also varied according to the histopathological change.
    In the 5-FU cases no pulmonary change was observed, where as the submandibular gland alone underwent morphological change. Furthermore, under Vincristin and Cycrophosphamide administration both tissues showed no change.
    These findings indicate that under the administration of BLM and its analogues, observing the change in the salivary glands biochemically and histopathologically may contribute to early prediction of pulmonary fibrosis.
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  • 1. Experimental model of DIC induced by endotoxin in rabbits and diagnostic criteria for DIC (DIC score)
    Hiroshi FUJITA, Kunio SEKINOH, Kiyohito YAMAZAKI, Masafumi SHIMAZU, Sh ...
    1987 Volume 33 Issue 7 Pages 1308-1320
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The purpose of the present study is to clarify the disease of disseminated intravascular coagulation (DIC).
    We designed an experimental model of DIC in rabbits induced by continuous infusion of endotoxin (ET) for three hours. The animals were divide into four groups as follows;
    Group I: infusion with ET (0.1mg/kg)+physiological saline
    Group II: infusion with ET (1.0mg/kg)+physiological saline
    Group III: infusion with ET (3.0mg/kg)+physiological saline
    Group IV: infusion with physiological saline only (control).
    Tentative diagnostic criteria for experimental DIC were proposed as DIC score including various blood parameters and pathological findings (micro-clot formation in lung and kidney). The results indicated that aggravations of blood parameters and pathological findings were dependent upon the dose of ET, and Group III made the highest score in on studies.
    From these results, we may conclude that Group III was considered to be useful as DIC model in rabbits.
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  • Shinichiro SUMITOMO
    1987 Volume 33 Issue 7 Pages 1321-1337
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The effects of serial and single administration with actinomycin D (ACT-D) and chromomycin A3 (CHRM) in mice submandibular gland (SMG) were examined by quantitative analysis and immunostaining for epidermal growth factor (EGF), morphometory, andautoradiography. Testosterone (TP) administration was carried out in the same groups of mice and compared with the groups administrated ACT-D and CHRM alone.
    In the normal SMG of mice immunohistochemically detectable EGF was localized in granular convoluted tubule (GCT) cells. EGF level in male SMG was 10 to 25 times greater than in female or castrated mice. By the serial administration of ACT-D and CHRM, EGF staining was still confined to GCT cells but cell-to-cell variations of EGF staining became move conspicuous, and the ratio of “EGF positive cells”/SMG, and EGF level in SMG were significantly decreased. In serial TP administrated group, GCT cells increased in both size and numbers, and EGF levels in their SMGs were much higher than in the normal and strong EGF staining was found in GCT cells. In the groups that ACT-D or CHRM were used together with TP, the ratio of GCT/SMG and “EGF positive cells”/SMG, and EGF concentration in SMG were almost same as in the normal.
    In the normal SMG of female mice, a small number of nuclei in both intercalated and acinar cells were labeled with 3H-thymidine. Incorporation of 3H-uridine was little higher in acinar cells than in GCT cells. By the single injection of TP, incorporations of both precursors were increased and the peaks of incorporation of 3H-thymidine and 3H-uridine were the second and the third day after injection, respectively. At that time, 3H-thymidine labeled nuclei existed in some GCT cells and 3H-uridine was found in both GCT and acinar cells in almost the same frequency. When ACT-D or CHRM were used together with TP, incorporations of precursors were almost the same as in the normal.
    The present results suggest that ACT-D and CHRM inhibit not only RNA synthesis but also EGF and DNA synthesis in mice SMG. Furthermore, ACT-D and CHRM may disturb the effects of TP in GCT cells.
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  • Radiographic and histopathologic findings
    Yohko FUKUTA
    1987 Volume 33 Issue 7 Pages 1338-1356
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A clinico-pathological analysis on 54 cases of benign fibro-osseous lesions of the laws was made and Nomarski reflection microscopic and scanning electron microscopic findings of these lesions were added. These cases were classified according to WHO's classification, i. e. 35 cases of cementoma (including 2 cases of benign cementoblastoma, 8 of cementifying fibroma, 23 of periapical cemental dysplasia, 2 of gigantiform cementoma), 9 of ossifying fibroma, 3 of fibrous dysplasia, 2 of benign osteoblastoma, and 5 other cases which could not be classified as any other diagnosable disease. 13 cases were multiple lesions which were all cementomas.
    Nomarski reflection microscopy was useful to observe hard tissues and distinguish cementum from bone. The collagen fibers were found to be arranged more crowded than those of the bone and vertical to the cementum according to scanning electron microscopy.
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  • Hiromichi AKIZUKI, Hiroshi YOSHIDA, Katurou TUKIOKA, Kimie MORI, Takas ...
    1987 Volume 33 Issue 7 Pages 1357-1362
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    This report analyzes the maxillofacial injuries of 521 patients treated at First Department of Oral and Maxillofacial Surgery, Showa University Dental Hospital in 1977-1985. The injuries were classified into four groups, depending on severity: Group 1, maxillary, mandibular and maler fracture; Group 2, tooth injury; Group 3, injury of oral soft tissue; Group 4, decubital ulcer of oral soft tissue. Factors analyzed were number, sex, patient age, and cause, location and treatment of the injury. Tooth injuries (Group 2) were the largest with 45.3% of the patients, while Group 1 was 24.4%; Group 4, 15.6%; and Group 3, 14.8%. The male/female ratio indicated much more common fracture (Group 1) and tooth injury (Group 2) in male, while female had slightly higher occurrence of oral soft tissue injury (Group 3) and decubital ulcer (Group 4). Automobile accidents were the main cause of injuries in Group 1, falls in Group 2 and 3, prosthesis in Group 4. Just over ninety percent of fractures (Group 1) were of the mandible, and just over two-thirds of tooth injuries (67.8%) were in the maxillary incisal region. Soft tissue injuries (Group 3) occurred mainly in the lip (35.1%) and gingiva (17.5%). Decubital ulcers (Group 4) were found in gingiva (48.1%), tongue (27.2%) and buccal mucosa (12.3%). Most fracture patients were successfully treated by closed reduction and about sixteen percent of patients were treated by open reduction. Fifty-six percent of tooth injuries (Group 2) were luxated teeth, most of which were treated by repositioning and fixation.
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  • Yoshikuni SANGU, Mari ITO, Yasuhiro YAMASHITA, Hideki OGIUCHI
    1987 Volume 33 Issue 7 Pages 1363-1366
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Aneurysm of the extracranial carotid artery is an uncommon lesion mostly found in the common carotid artery and its branches. Aneurysm of internal carotid artery is extremely rare.
    Generally symptoms are often suggested by the pulsatile nature of the lesion, in certain patients the enlarging aneurysm may cause a bulge in the area of the tonsillar fossa, hoarse voice and disphagia. Therefore the diagnosis is comparatively simple. But definitive diagnosis should be obtained by angiography that can discriminates other lesions.
    A case of an aneurysm of internal carotid artery obtained by computed tomography and angiography findings was reported. The patient was a 73 year-old female who complained of a left pharyngeal bulge. We abondoned the idea of doing an operation because of possible development of severe post operative symptoms of cerebral ischemia, and selected symptomatic treatment that avoids promoting aneurysm growth and rupture and keeping the present condition.
    Fortunately no change of symptom has been noted in seven months follow up.
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  • Yoshihito ISHIKAWA, Keigo KUDO, Akiyoshi KUJI, Mitsumasa YOKOTA, Kazus ...
    1987 Volume 33 Issue 7 Pages 1367-1372
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Seven split and 3 full thickness skin grafts for malignant tumors after radiotherapy were performed for the following purposes: Biological dressing and promotion of healing for resection wounds and retention of the reduction after marsupialization wounds of the maxillary sinus. The skin grafts were used for reconstruction of defects following surgery of the smaller superficial tumors. All grafts were taken from femoral skin. Recipient sites were as follows; 1 maxilla, 5 maxillae and buccal mucosae, 3 mandibles and 1 tongue. In 10 patients preoperative chemotherapy was carried out and also in 8 of them irradiation of 10-88 Gy.
    All grafts were alive and a necrotic bone piece each was found in the wounds of a maxilla and a mandible 1 or 2 months later. The skin grafts were very useful for insertion of denture except 1 patient with teeth and satisfactory results were obtained.
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  • Kasuke NAKASHIMA, Masamichi IDA, Yasuyuki UENO, Tatsuo Tsuji, Fumihiko ...
    1987 Volume 33 Issue 7 Pages 1373-1376
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Generally, the aneurysms are found on the arterial stems like the ascending, descending and thoracic aorta. The appearance of aneurysm on head and neck regions is very rare in the literature. However, recently we experienced a case of true aneurysm on the buccal region.
    Almost all of these cases have been false aneurysm resulting from traumatic, iatrogenic or other causes. This lesion occurred on a 21 year-old fireman. Clinical examination showed the left buccal to have diffusal swelling, and to produce a pulsating and aneurysmal bruit. The patient has not experienced any facial trauma, fracture, operative sequelae or other causes usually associated with a false aneurysm. Histopathologically, the extirpated rami buccales tissue exhibited a bilocular construction, while the structure of the arterial wall was of external, medial and internal layers with no apparent defect of lamination. The elastic fiber of the arterial wall was found to exhibit plasmotomy and absorption strongly supporting the diagnosis of a true sneurysm.
    The operation method was as followed: The transverse cutaneous excision ran along the mandible to the mandibular angle and down the frontal edge of the sternocleidomastoid muscle to form an inverted triangular flap. The external carotid artery was abrased, and the rami buccalaes was ligated at its junction with the external carotid artery. A small section of the rami buccales was excised and examined microscopically. Finally the excised flap was closed by stereotaxic suture.
    The operation resulted in the subsidence of both buccal swelling and aneurysmal bruit.
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  • Localized alveo-plasty with granulate hydroxyapatite ceramics
    Kenji KURASHINA, Toshikazu MINEMURA, Susumu TAKEDA, Akira KOTANI, Tosh ...
    1987 Volume 33 Issue 7 Pages 1377-1382
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Three cases of localized alveo-plasty with granulate hydroxyapatite (HAP) are reported. In two of the cases, a gingivo-periostum tunneling technique was used for placing HAP. In one, HAP was placed directly on the surface of the exposed maxillar bone. Dehiscency with little HAP loss was seen in one case. No trouble took place during the post-operative course in the other two cases. This alveo-plasty with HAP can be carried out easily and the improvement of the alveolar ridge contour is a solution for prosthodontic and oral hygienic problems in cases of alveolar ridge resorption or defect.
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  • Koumei SHIGEMURA, Tatsuo TSUJI, Kouji MATSUMURA, Atsuo HIROZANE, Yasuy ...
    1987 Volume 33 Issue 7 Pages 1383-1386
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    A 73-year-old female was admitted to our hospital with a complaint of left temporal swelling. She had a history of gingival adenoid cystic carcinoma in 1967, and was operated for left maxillary cancer including a partial resection with left selective lymphnode resection. Radium needle application was done against recurrence at that time. After these treatments, she was cancer free until November, 1980.
    Pathological examination showed recurrence in the gingiva around maxillary defect. CT scan revealed that the tumor proliferated from the maxilla to the left temporal region. It was suspected that it has mestasted to brain. Chemoserapy using adriamycin and mitomycin C, and x-ray irradiation therapy had been done effectively. The tumor in the temporal region decreased in size after these therapies.
    We reported a case of adenoid cystic carcinoma that recurred 13 years after the first treatment. The pertinent literature was reviewed and the clinical procedure discussed.
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  • Nobumi OGI, Masayuki SUGIURA, Naoyoshi HAYAKAWA, Yoichiro KAMEYAMA, Ke ...
    1987 Volume 33 Issue 7 Pages 1387-1391
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    The incidence of tuberculosis has been reduced recently but is still a health problem of major concern. Tuberculosis involving the tongue is uncommon. Pulmonary tuberculous patients rarely develop lesions of the tongue, although the lesions are generally secondary manifestations of pulmonary involvement. A case of tuberculosis of the tongue is presented.
    A 46 year-old man who had been hospitalized for lung tuberculosis 25 years ago was referred for treatment of a lingual lesion. A shallow and painful 8 by 14mm, ulceration, with a slightly indurated margin was overlying the lingual dorsum. Laboratory studies were performed. Complete blood count and blood biochemistry revealed nothing significant except for CRP (3 plus) and A/G(1.00). Tuberculin skin test gave a positive result. Reaction of sputum to acid-fast stain was negative but culture was positive. Radiographs of the chest showed recurrence of old tuberculosis in the right upper lobe.
    The diagnosis was established by histopathological examination. Anti-tuberculous treatment was started on the evidence of the clinical and laboratory findings. Local treatment was application of rifampicin ointment. The ulceration healed 60 days after commencement of treatment. The patient was followed up.
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  • Gaku YAMAMOTO, Kazusada YOSHITAKE, Toshihiko HIROBE, Katsuhiko YOSHIDA ...
    1987 Volume 33 Issue 7 Pages 1392-1399
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Sjögren's Syndrome (SjS) frequently supervenes diseases of other organs such as rheumatoid arthritis, chronic thyroiditis or chronic active hepatitis. Recently, we encountered a case which showed dry mouth seven years after thyroid tumor surgery and diagnosed as SjS at the fourth year of sicca condition.
    The patient was a 74-year-old Japanese female who was initially examined in our clinic on April 16, 1985 with a chief complaint of xerostomia. In her past history, there were hysterectomy and ovariectomy at age 37. Around that time she noticed a tumor in her neck which was treated by medication. She underwent surgery for volvuls at 43 and for thyroid adenocarcinoma at age 63. However the latter showed local recurrence 3 years later and metastasis (rice grain size) in the right parotid gland another 4 years, both had been successfully resected. Pyeronephritis developed at age 73. She had no experience of radiotherapy. Her familyhistory disclosed cancer, hypertension and allergy. As for the history of present illness, dry mouth appeared at age 70 when she underwent parotid gland operation.
    Her physique and nutritional status on our initial examination were moderate. There was oligosialia. The tongue surface was slightly smooth and red, and oral mucosa was thin and atrophic. Her residual teeth were 6 incisors and 4 canines in upper and lower jaws with several decays. While the peripheral blood and liver function tests were within normal limits, remarkable sicca syndrome related data were obtained as follows: total protein was 8.7mg/dl; γ-globulin 21.2%; ESR 32mm/h; RA test 2+; and amylase isozime-S 20.8 SU. The result of biopsy of the minor salivary gland was grade 2, with aggregate inflammatory cells. Scintigraphy by TcO4- visualized a defect on right side of the thyroid gland and a flat time activity curve in every salivary gland. Sialography on left parotid gland showed typical globular pattern. The diagnosis of SjS was made. The patient is now under symptomatic therapy with artificial saliva, bromhexin and lysozyme.
    Considering the well known association of Hashimoto's chronic thyroiditis with SjS, it was speculated that the long term presence of thyroid tumor induced some type of immunological disorder in the host to lead to SjS.
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  • Etsuhide YAMAMOTO, Ryoji TSUTSUMIDA, Gen-iku KOHAMA
    1987 Volume 33 Issue 7 Pages 1400-1409
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Histological findings of squamous ell carcinoma in the oral cavity vary in each case. Among them, mode of invasion in the tumor-host borderline is a most important factor related with prognoses of the patients. Tumor cells of Grade 4D, that was subclassified from Jacobssons Grade 4 by us in 1982, invade diffusely with a single or a few cells group. At present, cases with Grade 4D were re-evaluated clinicopathologically and the following results were obtained. Cases with Grade 4D were observed in only 16 out of 161 cases (9.9%) with tumor sites of 8 in tongue, 4 in buccal mucosa, 3 in lower gum and one in floor of the mouth. Objective response by preoperative administration of 90 mg of BLM only or 1, 000mg of MTX and 60mg of BLM was obtained in 5 cases (31.3%). Regional lymph node metastases were found in 13 with 8 cases of extra nodal spread. Postoperative course of these cases showed a highest maligancy with 8 local recurrences, 4 secondary metastases and 11 deaths from tumor. Survival rate was, therefore, only 21.4%(3/14). It was judged from these results that, if surgical procedure was chosen, wide local excision and prophylactic neck dissection were neccessary for these cases.
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  • Masaaki SASAGURI, Satoru OZEKI, Manabu OKAMOTO, Hiroko HARA, Hideo TAS ...
    1987 Volume 33 Issue 7 Pages 1410-1416
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    During a period of 22 years, from 1963 to 1984, 45 primary patients with squamous cell carcinoma of the floor of the mouth were treated at the Department of Oral Surgery, Kyusyu University. Of these 45 patients, 38(84.4%) were male.
    According to the TNM-classification of the UICC (1978), 9 cases were T1, 23 were T2 and 7 were T3. The other 6 cases were classified T4 because of massive tongue and bone invasion. In stage grouping, 7 cases belonged to stage I, 11 to II, 13 to III and 14 to IV. In 30 cases, the primary lesions of the floor of the mouth arose in the anterior part to bilateral canines, and in 15 cases in the posterior part. In most instances the lesions were ulcerated, and particularly endophytic type with deep ulceration were seen in advanced condition.
    In principle, squamous cell carcinomas of the floor of the mouth were treated in our department as follows; In stage I·II cases, interstitial radium therapy or resection only was performed. Stage III·IV cases received surgical treatment combined with preoperative external radiaton and bleomycin. When the primary lesion was controlled by this combined therapy radiation and bleomycin, surgery was not performed. Five cases of 7 in T3 category were treated only with this combined therapy without surgical treatment.
    The reconstruction of oral cavity after en bloc operation were performed with cervical island skin flap in most T2 cases, and segmental mandiblectomy or subtotal glossectomy was followed by the reconstruction with Pectoralis Major Myocutaneous flap.
    Of 6 recurrent cases, 4 patients died of primary lesion recurrence, one died of other illness and one is alive. Metastasis to the cervical lymph nodes were histologically confirmed in 15 cases. Secondary and bilateral metastasis was noted in 5 and 4 cases respectively.
    The survival rate in all cases was 61.9% by 5 years (T1, 63.7%; T2, 65.2%; T3, 71.3%; T4, 42.8%), 5 years survival rate was 67.4% in cases treated by interstitial radium therapy, 63.2% by combined therapy of radiation and bleomycin, 62.2% by surgery combined with preoperative radiation and bleomycin. The survival rate was significantly higher in cases without metastasis (78.6%) compared with cases with metastasis (38.6%).
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  • Sadahiko KONDO, Akira KAWAKITA, Kenichi KURITA, Yutaka YAMADA
    1987 Volume 33 Issue 7 Pages 1417-1423
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    We devised a new appliance, an oropharyngeal airway tube combined with a maxillary plate, to correct obstructive sleep apnea in a four-month infant with crouzon, hydrocephalus, and choanal atresia. This appliance was used for six months and had the following outstanding results.
    1) It is easy to place the tip of the tube at the obstructive portion of the airway.
    2) The tube does not deviate from the first position even after several usages, which is an improvement on other airways.
    3) It is possible for infants to keep the tip of the tube in the space of the lower pharynx by adhesion of the plate to the maxilla even if they move very much.
    4) This appliance can be in the oral cavity for a long time.
    5) This appliance is easier to put into place and take out compared with other airways.
    6) The infant tries to push the large appliance out of its mouth, resulting in development of the muscles which correct obstructive sleep apnea.
    7) This appliance can be also useful in oro-nasal airway stenosis.
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  • Yasunori SATO, ISOO NOGUCHI, Toshifumi ANDO, Masayuki TAKAHASHI, Shige ...
    1987 Volume 33 Issue 7 Pages 1424-1429
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Odontogenic sinusitis is induced due to the anatomical relation between the maxillary sinus basis and the maxillary molar teeth, which is already well-known. On the other hand, it is also known that inflammation in the maxillary sinus involves the orbita to cause disorders owing to the anatomical relation with relatively thin osteal wall separating the maxillary sinus and the orbita, but it seems relatively rare that odontogenic sinusitis is associated with symptoms such as exophthalmos and diplopia, etc. In the present paper we report, with some considerations, a case of right odontogenic sinusitis resulting in marked ophthalmologic symptoms which we recently experienced.
    Our subject was a 34-year-old male. He left pain at the right maxillary molar region about 3 weeks before the first visit to our hospital. The pain intensified with the appearance of cold symptoms 2 days before the first visit. On the first visit, we found swelling in the right maxillary, cheek, and orbital regions, and he was hospitalized. Ophthalmologic symptoms included exophthalmos, palpebral swelling, diplopia, and narrowed visual field, etc., were improved after the antiinflammatory treatment. Five months have passed since extraction of causative teeth and radical operation for sinusitis with a favorable course without relapse.
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  • Masaaki KOGA, Wataru SOEJIMA, Hisato KAMURA, Yasuhiro FUKUCHI, Masaaki ...
    1987 Volume 33 Issue 7 Pages 1430-1435
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Pleomorphic adenomas arises most frequently from the parotid glands. In the oral cavity, they occur in such various areas as the palate, cheeks, floor of mouth, tongue and lips.
    This report represents a case of pleomorphic adenoma in the soft palate which we recently experienced.
    Case: A 81 year-old female was referred to us with slowly enlarging, painless swelling in the soft palate. She complained of dysphagia. Clinical examination revealed a soft nontender mass in the soft palate. Uvula was pushed toward the unaffected side. There was no induration, mucosal ulceration, cervical lymphadenopathy or palsy of cranial nerves (VII, IX, X, XI). An attempted biopsy of the tumor was aborted because of profuse bleeding. After admission, digital subtraction angiography (DSA) revealed hypervascular mass. Selective embolization was performed for the preoperative devascularization of the hypervascular neoplasm. Surgical removal of the tumor was accomplished with total blood loss of only 160ml. The postoperative couse was uneventful with no sign of tumor recurrence.
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  • Sigeru HORI, Yoichi KURACHI, Kimitoshi YAGAMI, Keiko KANEMOTO, Hiroki ...
    1987 Volume 33 Issue 7 Pages 1436-1441
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    Myxoma is rarely found in the gingival region.
    We recently experienced two cases of myxoma arising in the gingival region of a 59-year-old male and a 97-year-old female. The tumors were excised under local anesthesia. Histological examination revealed stellate and spindle-shaped cells arranged in a loose mucoid stroma also containing collagen fibers, as is typical of myxoma.
    The prognoses of these cases are favorable with no signs of recurrence.
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  • Hisashi ADACHI, Tadahiko IIZUKA, Masahiro NOSE, Yoshihiko YOKOE, Ikuko ...
    1987 Volume 33 Issue 7 Pages 1442-1449
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    216 patients with malignant neoplasms in the oral and maxillofacial region were retrospectively studied. All patients were treated in the Department of Oral and Maxillofacial Surgery, Kyoto University Hospital during the 10 year period from 1973 to 1982.
    In 204 cases of the carcinomas, 89.2% were pathologically diagnosed as squamous cell carcinoma, most sited on the gingiva. More than 70% of the carcinomas in oral cavity were clinically advanced cases (stage III or IV), most cases were treated by surgery (S) +irradiation (R) +chemotherapy (C) or by surgery in combination with irradiation therapy.
    The 5 year survival rate in each combination therapy was 72. 4%(S+R+C), 77%(S+R), 30%(R+C), and the over all 5 year survival rate was 55.7%.
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  • Koji KINO, Hiroyuki WAKE, Yukou IZUMI, Yoshiaki OHMURA, Etzuro KUROKAW ...
    1987 Volume 33 Issue 7 Pages 1450-1457
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw.
    This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic.
    The areas of tenderness and jaw-opening pain in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 1% Xylocaine. Maximum interincisal distance was similarly recorded.
    The results were as follows:
    In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia.
    After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the digastric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50-60%.
    Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90-100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%.
    These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jawclosing muscles are referred pains from the temporomandibular joint.
    The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper.
    Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.
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  • Hideyuki HASEGAWA, Masayori SHIRAKAWA, Shigeru SAKUMA, Makoto NAKAMURA ...
    1987 Volume 33 Issue 7 Pages 1458-1464
    Published: July 20, 1987
    Released on J-STAGE: July 25, 2011
    JOURNAL FREE ACCESS
    In recent years, there has been some controversy concerning the relation between primordial cyst and odontogenic kerato cyst and a definite conclusion has not been obtained yet.
    Further, due to vague criteria of diagnosis for fissural cyst, classification of jaw cyst seems to be confused.
    We experienced a patient who underwent several examinations under clinical diagnosis of fissural cyst and finally diagnosed as non-keratinizing primordial cyst.
    Thus, we describe on an outline of this case addiscuss the classification of jaw cyst.
    The patient was a 25-year-old female who visited our hospital with chief complaint of pain of median palate. Examination revealed a relatively discrete swelling about pigeon egg size in the median palate from which a fluid with pus cells was aspirated.
    X-ray findings revealed a discrete, pear-shaped, bone radiolucent picture about pigeon egg size in the region between the bilateral median incisal teeth and the hard palate, and bilateral inflammation of the central incisor root spread centrifugally. Under a clinical diagnosis of fissural cyst, cystectomy was conducted under local anesthesia on December 21, 1984. Histopathological findings revealed that the cystic wall was thin and the epithelial layer consisted of stratified squamous epithelium. Loss of epithelial projection to the subepithelium and alignment of the cylindrical basal cells in the lowest layer of epithelium were noted. Abcess and hemorrhagic nest as well as cellular infiltration with severe inflammation were observed in the subepithelium. The epithelium was invaded by inflammation and epithelial alignment was disturbed. Namely, an established diagnosis of non-keratinizing primordial cyst was made from the following points: 1) pathological findings accorded with the findings of primordial epithelium, 2) no relation between this lesion and the incisal canal was observed from the findings during operation, 3) the lesion was distinguished from nasopalatine cyst, 4) there was no definite evidence to diagnose fissural cyst and 5) there was full significance of existence of non-keratinizing primordial cyst, In this paper, we further discussed the classification of jaw cyst.
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