This study was designed to determine the effect of serial temperature on cell proliferation in the culture of epithelial cells obtained from oral mucosa of the adult rabbit and human reonate.
Oral epithelial cells were collected by treatment with EDTA and trypsin. Swiss 3T3 cells which had been previously irradiated by ⁶⁰Co (6, 000 rad) were used as a nutrient layer in some culture.
A “primaria dish” was used in other cultures without nutrient, in order to determine the possible direct action of growth stimulating factors such as EGF, cholera toxin and retinoic acid. A modified MCDB 152 medium containing insulin, hydrocortisone and transferin was used. A new gradient temperature incubator able to simultaneously set different temperatures was used.
The medium was changed every 3 days, and on the 8 th day when the maximum number of colonies was reached, the cultured materials were fixed and stained with May-Grtinwald's solution and Giemsa's solution respectively. Numbers of colonies of 8 or more cells were counted on the bottom surface of the dishes with 24 wells through an inverted microscope. The mean and standard deviation were calculated for every set culture consisting of 3 or 6 wells in the same condition. The statistical difference between the culture sets was obtained by the t-test.
Results of this study show, that:
1. Although a small fluctuation of between 0.2 to 0.4°C in average temperature was measured resulting from room temperature changes, the water cooling incubator system was found to be reliable, so that relatively stable temperatures were obtained at every temperature setting.
2. When oral epithelial cells from the adult rabbit were cultured at the low-temperature level of 33. 4-34. 0°C, the number of colonies was greater than at the high-temperature level of 36. 0-37. 0°C, regardless of the use of a feeder layer.
3. Colony formation was stimulated by the addition of EGF and cholera toxin. However, colony formation was still greater at the low-temperature level. It was therefore obvious that temperature acted on colony formation independently from stimulation.
4. The addition of retinoic acid increased colony numbers regardless of the use of the feeder layer at a temperature range of 32. 0 to 35. 0°C. Numbers decreased at the low tem-perature of 31. 8 °C and the high level of 36. 1°C. Adenocyte-like colonies, frequently observed when retinoic acid was added, showed a similar thermal response.
5. The number of colonies of fibroblast-like cells remained small when cultured at the low temperature of 33. 0 C. However, numbers increased as the temperature rose. Therefore, at least as far as rabbits were concerned, a distinct difference was found in the optimal temperature for the culture of epithelial and fibroblast-like cells.
6. For immature-type colony formation of human new-born epithelial cells, the low temperature level of 34. 4 QC was most effective. However, blast-cell type colonies multiplied in a thermal-dependent fashion and the high-temperature of 36. 5 °C was optimal.
In addition, number of cells per colony reached maximum at the high temperature level of between 35. 6 and 36. 8°C.
7. Previous observations of epithelial cell-type growth were confirmed; it become obvious that the optimal temperature range for proliferation differed for the two cell types.
Furthermore, it appears that the blast-cell type colony originated from either epithelial stem or progenitor cells and that the immature-type colony cells were markedly similar to cells of the suprabasal region of the epithelium.

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There have long been arguments on the existence or otherwise of a periosteal osteogenic capacity.
In more recent experiments many investigaters have supported this concept. However, few studies have been made on this capacity in the aged.
The purpose of this paper is to restudy osteogenic capacity in the periosteum and to compare differences in this capacity with advancing age.
Japanese white rabbits were divided into 3 groups by age; 1-month, 1-year and 1 1/2 year old periosteum was removed from the shaft of the ulna and immediately free grafted into muscle of the anterior forearm. Samples from these animals were examined by X-ray and light microscope.
The following results were obtained;
1) New bone formation in the grafted periosteum occurred in 42 (70%) out of 60 cases.
2) The developmental stage of new bone formation was more rapid in young rabbits than in adult ones.
The results of these experiments indicate that the periosteum has an osteogenic capacity, greater in younger rabbits.

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To introduce radiofrequency hyperthermia delivered through HEH 500 C (13.56 MHz) on head and neck tumors, especially on oral cancer, an experimental study has been made as to the effect of RF waves on metals and mandibular bone in the phantom circumference. As a result, it was found that heated hot spots around both distal edges of metal were recognized in thermal video image when any metal was placed in a vertical situation, but there was only a little effect when the metal is placed in parallel between applicators.
When dry mandibular bone was placed between applicators, almost same temperatures were measured at both internal and external sites of the bone in phantom.These, results show that radiofrequency hyperthermia will be able to make suitable heat even metals and bone exist between applicators.
On a clinical trial, a case of non-measurable residual carcinoma of the floor of the mouth underwent 6 sessions of hyperthermia combined with irradiation as 4 preoperative treatment. The mandible which had been reconstructed by A-O plate at previous surgery revealed a partial response after treatment.The interruption by both metal and mandibular bone to gain 4 suitable intratumoral temperature higher than 42.5 degree C was fortunately small.

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This study was designed to determine the effect of bilateral extraction of all molars and premolars on glycosaminoglycans (GAG) in the synovial fluid of the monkey temporomandibular joint (TMJ). TMJ radiographs were taken using standard techniques at intervals of 2, 4, 8, 16, and 24 weeks following surgery. The synovial fluid was digested with pronase E and GAG were extracted using CPC at intervals of 2, 8, 16, and 24 weeks following surgery. Qualitative and quantitative changes in the GAG were examined by the carbazole reaction and electrophoresis on a cellulose acetate strip. The molecular weight distribution of GAG was examined by gel chromatography.
The following results were obtained
1) No morphological changes were observed in the condylar head or articular eminence, although the position of the condyle changed in a superoposterior direction in the 16 and 24 week groups.
2) The GAG was composed of hyaluronic acid (HA) only.
3) HA concentration as uronic acid was initially 2. 13 mg/m/, gradually decreasing with time.
4) Gel chromatogrophy-measured HA in the experimental groups was eluated later than the control group, indicating a decrease in the molecular size of HA in the experimental groups. Decreased molecular size of HA was observed up until the 16 week; an increase to the 2 week level was observed in the 24 week group.
It is suggested that bilateral extraction of molars in monkeys caused quantitative and qualitative changes in the HA of the synovial fluid.

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The ultrastructure of two cases of pemphigus vulgaris were examined by transmission, scanning and immunoelectron microscopy. Confirming previous reports, major alterations included edema or widening of the intercellular spaces, acantholysis, destruction of desmosomes and formation of tonofilamentous bundles surrounding the nucleus of acantholytic cells. Membrane-coated granules were also observed both within the cytoplasm near the cellular membrane and in the widened intercellular spaces. Some of these intracellular granules assumed a desmosome-like appearance. Basement membrane features varied. The anchoring filament was usually not altered. The lamina densa varied from normal to a widened appearance, interrupted and even completely lacking. Exfoliation in places of basal cells from the lamina densa was also noted. Under IEM, deposition of colloid gold conjugated anti-IgG and anti-IgA antibodies was noted mostly on the cytoplasmic membrane and the widened intercellular spaces. Three dimensional morphological alterations were demonstrated by SEM. Cytoplasmic projections of the acantholytic cells were shortened and had assumed a bead appearance. Cellular interdigitations were completely lost. Before vesicular formation, intraepithelial micro-vesicles and widening of the epithelial cells could be demonstrated on cracking fractured specimens. In this stage, although interdigitations between neighboring cells were preserved, cytoplasmic projections facing the micro-vesicle were shortened.

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The effects of mandibular immobilization on the monkey masseter muscle were studied histochemically and ultrastructurally. Mg²⁺-ATPase activity was observed cytochemically.
Mandibles were immobilized by intermaxillary wire fixation in the intercuspal position. The masseter muscle was examined at 1, 4, 6 and 8 weeks after immobilization.
Histopathologically, fiber diameters were slightly reduced after 4 weeks of immobilization; these changes continued after longer periods of immobilization. Histochemically, no specific changes were detected. Ultrastructurally, myofibril architectural changes included a partial reduction in numbers and fragmentation of the Z-line at 1 week after immobilization. Granular electron-dense materials were noted among the myofibrils. The degenerating zone of the fi ber increased at 4, 6 and 8 weeks after immobilization. Central core structures and tubular aggregates were found in the muscle fiber at 6 weeks post immobilization. At 6 and 8 weeks segmental necrosis of the fiber was noted. The Mg²⁺-ATPase activity in the normal masseter muscle was localized in the sarcolemmae, caveolae, terminal cisternae of the sarcoplasmic reticulum and matrices of mitochondria. At 8 weeks Mg²⁺-ATPase activity decreased as compared with control muscle.
Immobilization of the mandible results in various morphological and cytochemical changes in masseter muscle. It is suggested that degeneration of the masseter muscle is an important factor in dysfunction occurring after release of intermaxillary fixation.

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Great importance has been attached to environmental factors as causes of abnormality; several studies have been reported.
The author examined the occurrence of abnormality due to infection-induced inflammation.
Materials and methods were as follows: ddY mice were used. The first day of pregnancy was considered to be the day a plug was found. Some pregnant females were given injections of Staphylococcus aureus suspention in the dorsal subcutaneous tissue and the others in the fl oor of the mouth 11th day of gestation. Animals were sacrificed on the 16th to 17th day of gestation.
The implantations, dead fetuses and the presence of cleft palate were noted.
The results obtained were as follows:
1. In the group infected with staphylococcus aureus in the dorsal subcutaneous tissue, incidence of cleft palate was 1. 92% on the 10 th day, 0.64% on the 11 th day, and 0% on the 12 th day of pregnancy.
2. In the group injected with saline in the dorsal subcutaneous tissue, incidence of cleft palate was 0% on the 10 th, 11 th, and 12 th day of pregnancy.
3. In the group infected with staphylococcus aureus in the floor of the mouth, incidence of cleft palate was 4.35% on 10 th, 10.0% on 11th, and 8 74% on 12th day of pregnancy.
4. In the group injected with saline in the oral floor, incidence of cleft palate was 0% on the 10 th, 11 th, and 12th day of pregnancy.
5. From the above results, it is suggested that inflammation due to infection is a possible cause of cleft palate.

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Mechanical analysis of the tooth root and alveolar socket under extraction force is important in the serarch for more effective and safer methods of extraction, and also to prevent fractures of the tooth root and alveolar process and other accidents. A study was, therefore, made of the mechanical behavior of the tooth and alveolar socket under various loadings using the finite element method. A computer numerical analysis.
A two-dimensional numerical model of the lower first premolar was developed, and loaded with cantilever and wedge forces with elevator, and forceps force. In particular, elevator depth insertion direction of insertion, and blade angle were changed in order to investigate the effects of extraction force by elevation. As a result, mechanical behavior of the tooth root and the alveolar socket under loading was clearly shown, and conventional tooth extraction methods were justified by stress analysis.

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Mechanical analysis of the tooth root and the alveolar socket under extraction force is important in searching a more effective and safer method of extraction, and also in preventing fractures of the tooth root and the alveolar process and other accidents. Therefore, a study was made of the mechanical behavior of the tooth and the alveolar socket under various loadings, following the finite element method, which is a numerical analysis processed by computer. Two-dimensional numerical model of the lower first molar and the upper first molar were developed, and the models were loaded with cantilever and wedge forces with an elevator and forceps force. Especially, the depth of the inserted elevator, direction of insertion, and blade angle were changed to investigate the effects of extraction force with the elevator. As a result, mechanical behavior of the tooth root and the alveolar socket under loading was clearly shown, and conventional methods of tooth extraction were supported from the viewpoints of the stress analysis.

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Experiments were performed to investigate regrowth of the rat sciatic nerve through lyophilized heterografts of 10mm length prepared from the rabbit or rat sciatic nerve. The results were as the following:
1) Regenerating axons were able to extend through the grafted nerve in both the hetero and homografted lyophilized nerves. However, regrowth through the hetero grafts was delayed by about 4 weeks as assessed by the number of regenerating nerve fibers, latency of the EMG evoked by electrically stimulating the ipsilateral sciatic nerve, and time course of the concentration of γ-enolase in the nerve.
2) Regeneration was apparently retarded by inflammatory responses, but once regenerated axons passed through the hetero graft in which intense connective tissue proliferation was noted, regeneration proceeded rapidly, eventually catching the recovery rate of the homo grafted group. At the end of the 48 week observation period no significant differences between hetero and homografted groups were noted in terms of evoked EMG latency, rate of myelinated fiber regeneration, and γ-enolase concentration in the nerve.
3) In both the hetero and homografted groups, the recovery of β-enolase concentration of the muscles started from the 8 th postoperative week. The recovery of wet weight of the muscles on the operated side started from the 12 th postoperative week in the hetero grafted group, and from the 8 th postoperative week in the homografted group.
4) The degree of recovery of the wet weight of the fast-twitch muscles was superior to that of the slow-twitch muscles. As to β-enolase concentrations the fast-twitch muscles recovered to near-normal levels, while the slow-twitch muscles increased to attain a level between normal fast-and slow-twitch muscle levels.
To summarize, although there is a small difference in the period immediately after operation, lyophilized hetero and homografts can, within 48 postoperative weeks, have comparable properties measurable by histological, electrophysiological and biochemical methods.

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We are maintaining three strains of mice, A/J, CL/Fr, A/Wy with spontaneous cleft lip and palate in an attempt to investigate genetic and fetal environmental influences on the development of teratogenecity. In this paper, we report our findings on the spontaneous incidences of such deformity in A/J strain mice raised in our laboratory. We confirmed vaginal embolus of mother animals used for experiments on the day after mating, designated as the zero pregnant day. As the secondary palate closes around the 15 th embryonic day in A/J strain mice, mother animals were sacrificed by cervical dislocation on the 18 th embryonic day; fetuses were then removed by cesarean section for observation. As a result, the mean fetuses implantation rate was confirmed to be 11.03 out of 51 samples with 7.35 living fetuses on average, of which 8.8% showed cleft lip and/or palate. When classified by cleft type, cleft lip was observed in 0 (0%), cleft lip and palate in 23 (69.7%), and cleft palate 10 (30.3%).

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Clinical evaluations were performed on 60 patients who had undergone orthognathic surgery in our clinic during the 10 years from 1977 to 1987.
The results are summarized as follows:
1. Patient number gradually increased in number.
2. Male/female ratio was 1: 2.3.
3. Average age of the patients was 21.1 years.
4. 56 patients were diagnosed as having mandibular prognathism, 3 maxillo-mandibular asymmetry and 1 as maxillary prognathism.
5. The surgical method used in most patients was the so-called Obwegeser-Dal Pont method.
6. 8 patients underwent pre-and postoperative orthodontic treatment and 2 patients postoperative orthodontic treatment.
7. Changes of the facial soft-tissue profile after surgical correction were evaluated as satisfactory.

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The purpose of the present study was to evaluate subjectively by third persons the features of mandibular prognathism patients before and after surgical correction. Eye movement of the 30 third persons (15 males and 15 females) was measured by the cornea reflection method when shown face photographs of three mandibular prognathism patients as typical examples taken before and after surgical correction by the Obwegeser-Dal Pont method. Each photograph was presented for 5 seconds.
The results were as follows:
1. In two cases the total number of vision fixations showed little difference between the pre-operative face (Pre op.) and post-operative face (Post op.), but one case showed a downward trend in the Post op. Total duration of fixation and ratio of total duration of fixation to total number of fixations showed an upward trend in the Post op. compared with the Pre op. in all cases.
2. As to locations of the first, second and third fixation points, fixation tended to be earlier to the lip and the mandibular areas in the Pre op. than the Post op.
3. The 5-second presentation time was divided into 5 parts of 1 second each. In each part the duration of fixation at the lip area in the Pre op. was longer than in the Post op.
4. The latent time for fixation (time for first fixation at each area) at the eye and nose areas tended to shorter in the Post op. than the Pre op., but at the lip and mandibular areas it tended to be longer in the Post op. than the Pre op.
5. The number of fixations and the duration of fixation at the lip and mandibular areas showed greater reduction in the Post op. than the Pre op. At the eye area however they increased in the Post op. more than the Pre op., and at the nose area they showed little change. The difference in the number of fixations and the duration of fixation at the lip and mandibular areas between the Pre op. and Post op. tended to increase as the amount of mandibular backward positioning increased.
These results suggest the benefits of eye movement measurements in the evaluation of the features of mandibular prognathism patients before and after surgical correction.

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Preliminary study and clinical trials use of ra3iofrequency hyperthermia as part of the multidisciplinary management of head and neck cancer in combination with radiotherapy, chemotherapy, and surgery has been performed. In this series, 8 tumors in 7 patients (6 males and 1 female) treated in our department during 1987 were assessed respectively. Thermotherapy was applied to the following locations: 2 floor of the mouth, 2 mandible 2, buccal mucosa 1, parotid, and 1 neck. Total number of sessions hyperthermia was 50. Histopathologically heated tumors were 4 squamous cell carcinomas, 1 adenocarcinoma, 1 adenoidcystic carcinoma and 1 fibrosarcoma. Thermometry with a copper-constantan thermosensor was done via a Vennula tefron catheter placed into the tumor and kept in situ for the duration of treatment. As a result, effective intratumoral temperatures above 42.5 degree C were reached in 52% of all heated tumors. Efficacy of heating was determined by clinial palpation, computed tomography (CT), and isotopic examination.
Remarkable decreases in tumor density on CT and cessation of 67Ga uptake on scintigram were noted. The partial response rate was 75% in all 7 patients. Whole specimens taken from excised tumors showed extinctive cancer cell, tumor necrosis and fibrous tissue with the exception of peripheral areas. This study shows preoperative RF-inductive hyperthermia to be of benefit in the treatment of tomors of the head and neck in particular recurrent cancers.

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We report on a rare case of trismus caused by bilateral hypertrophy of the coronoid processes of the mandible. A 13-year old boy presented at our institute complaining of restricted mandible movement. An initial diagnosis of TMJ dysfunction was established, and routine therapy was instituted; however, his condition did not improve. A more thorough examination was undertaken; CT scanning revealed bilateral hyperplasia of the coronoid process. Both coronoid proces were surgically resected. Symptoms immediately disappeared. The condition appeared due to irritation within the zygomatic arch by the coronoid process.

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In order to evaluate patient satisfaction after surgical correction of prognathism, a questionnaire was sent to 52 patients at one year post surgery. The attitudes of 35 patients were analyzed. Results were as follows.
1. 14 of 35 cases complained of disturbed mastication and the same number of cosmetic dissafisfaction.
2. 29 cases were satisfied with post-surgical cosmetic appearance.
3. 9 of 16 cases noted improvmed pronunciation after surgery.
4. the size of tongue after surgery was not related to lingual movement.
5. Paresthesia was noted in 23 cases. 14 of the 23 cases noted subsequent resolution. Abnormal sensation remained in 9 cases. Symptoms of paresthesia were completely resolved within 6 months in 12 of the 14 cases (85.7%).
6. 17 of 27 cases complained of temporomandibular joint disorders, which do not resolve in 9 of the 17 cases. The other 8 cases showed no symptoms at one year post surgery.
7. 31 of 35 cases (88.6%) complained of some degree of intermaxillary fixation.

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Periapical cemental dysplasia is generally regarded as a disease that develops at the apical region of vital teeth as a result of proliferation of the connective tissue of the periodontal membrane, and uncommon benign odontogenic tumors of mesenchymal origin. The new histologic classification of “Cementoma” includes periapical dysplasia, cementifying fibroma, benign cementoblastoma and giantiform cementoma (familial multiple cementoma). Periapical cemental dysplasia is rare.
Moost common incidence is in middle age women, usually in the periapical regions of vital mandibular incisors. Occurence in the maxilla is very rare. The Patient complained of intermittent pain and swelling in the left buccal (maxillary sinus) region for 2 weeks, with concomitant maxillary sinusitis.
We report a case of multiple periapical cemental dysplasia occurring in the maxilla and mandible. The appearance on radiography, of the premolar region and the presence of premolar lesions in the maxilla suggest diagnosis of florid osseous dysplasia (FOD).

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A new method of ridge extension using hydroxyapatite particles is described. This method was applied to a patient who received transplanted iliac bone after the resection of gingival carcinoma. Ridge extension using autogenous bone has the disadvantage of possible resorption neccessitating further surgery. Hydroxyapatite however, is not absorbed and was therefore selected as being suitable for ridge extension. There are various types of hydroxyapatite ie porous particular, dense particular, porous block and dense block types.
Block type is most suitable for alveolar process formation, but perforation is a frequent problem. Porous particular type resists infection due to of discharging particle individually. Alveolar process formation is difficult, and suitable methods for the application of hydroxyapatite particles to the resected and reconstructed jaws have yet to be found.
We report a new method of ridge extension using hydroxyapatite particles, obtaining satisfactory results even in a unfavorable cases.

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Cenesthopathy is characterized by abnormal sensations sites in the body, which cannot be explained neurologically at various persistent. Symptoms are persistent.
These sensations range from cenesthopathy in the narrow sense with only one symptom to cenesthopathy in the wide sense in which partial symptoms of depression, schizophrenia, neurosis, the acute exogenic reaction type, etc. appear. These symptoms are often seen in the head and neck regions.
In the present study, we investigated two cases of cenesthopathy with symptoms in the oral cavity.
Case 1 was a 67 year-old female whose main symptom was the sensation of insects of various shapes moving around in her mouth, permanently attaching themselves to the teeth. After one month of diminished in size administration per os, sulpyride, the affected site and after 4 months. As a result of this symptom, was only a stretched feeling of the lower lip. As a result of this symptom, however, this patient developed hypochondria.
Case 2 was a 68 year-old female who was unable to walk without assistance for about 2 years because of chronic rheumatoid arthritis of 20 years duration. For about 4 months she had felt that a long thin pointed object had pierced an area with pain of unknown origin in the region of the upper molars, and that this object had gone deep into the buccal mucosa and could not be removed. She was administered sulpiride as there was also mental depression. On the 5 th day, the longstanding pain disappeared. Thereafter, the drug was changed to maprotiline and the background depression was completely alleviated.
Both of these patients recognized that their condition was of an irrational nature.

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Liposarcoma in the oral region is rare, although one of the most common malignant tumors in the soft tissues of the body in general. Liposarcoma usually arises in the deeper soft tissues such as the thighs, buttocks, and retroperitoneal area. Only three cases of liposarcoma in the floor of the mouth and tongue have been reported in the literature. Other sites in the oral region have been reported: seventeen in the cheek, five in the maxilla, three in the hard plate, two in the soft palate, one in the gingiva.
Case 1: This report deals with a case of well-differentiated liposarcoma (WHO classification) of the floor of the mouth in a 62-year-old man, completely excised under local anesthesia. on February 3, 1986.
Case 2: A 52-year-old man presented with a swelling on the right side of the tongue. Excisional biopsy revealed a myxoid liposarcoma. On September '14, 1987, subtotalglossectomy and upper neck dissection was performed.

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Hemangioma occasionally presents problems is treatment due to its size and location. In many cases, surgical operation is carried out but the danger of hemorrhage is present Recently, Nd-YAG laser was employed in surgical treatment of oral lesions, particularly in hemangioma as it presents no danger of hemorrhage. We cauterized buccal mucosal region hemangioma in a 10 year old boy using Nd-YAG laser. Output power was 20-30 w and total energy was 6, 000 J. No hemorrhage occurred during and after the operation. On 7th day, white plaque covered the wound surface and on the 21 st day complete epithelial coverage was noted. On the 28th day the wound was completely healed without scar formation and functional disorder.

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Three cases of isolated fragments in the maxillary sinus of 43 and 37 year old females and a 31-year old male were reported.
One was considered to be the result of chronic inflammation of the mucous membrane, and the other two cases due to embryonic abnormality occuring during the period of sinus pneumatization.

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Tumor marker substancies thought to be able to demonstrate recurrence or metastasis have been recently developmend. The specific reactivity of tumor markers is discussed.
In this paper, values obtained using Squamous Cell Carcinoma Antigen (Scc Ag) are determined in 20 cases of oral cancer, 36 malignancy follow-up cases, 30 cases of oral disease, 24 normal adults and 8 pediatric patients.
Results suggested that Scc antigen in Oral cancer is more useful in determining the presence of metastasis or distant metastasis than in finding local recurrence or primary diagnosis.
1) Of 18 new cases with squamous cell carcinoma, 6 cases (33%) showed higher Scc Ag values than the cut off value (2.0ng/ml).
2) Of 11 cases with confirmed recurrent squamous cell carcinoma, 4 cases (36%) exceeded the cut-off value.
3) 4 of 7 cases with metastatic cancer (57%) at the time of its diagnosis were positive. High values were obtained particularly in cases with distant metastasis and resulted in a poor prognosis.
4) The cut-off value for pediatric patients requires re-investigation.

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Treatment for actinomycosis of the left jaw and an improved arthroplasty technique with interposition of fascia temporalis for temporomandibular joint ankylosis resulting from the inflammation are discussed. Changes in post-surgical masticatory function were noted.
The patient was a 60-year-old woman refered to this center for evaluation of gradual onset immobility of the jaw. The maximum interincisal opening was 5mm, and obstinate swelling was noted in the temporal, buccal and mandibular areas. The WBC count was 10, 000 with 82.8 percent neutrophils. She had been infected with Actinomyces, thought to have entered through a denture wound on buccal mucosa. Upon hospitalization, drainge was established by intra and extra oral incisions. Actinomyces were found in the discharged exudate which did not contain characteristic sulfur granules. Antibiotic therapy for 47 days with sulbenicillin was required for complete remission of the lesion.
The patient was rehospitalized three years later due to progressive inability in opening the jaw, and arthroplasty was performed with a diagnosis of left temporomandibular joint ankylosis due to hypertrophic arthritis caused by inflammatory reaction of actinomycosis. Using the Al-Kayat Bramley incision, partial excision of the condylar head was performed, and fascia temporalis was taken, folded and inserted into the capsule in order to prevent the recurrence of ankylosis. A satisfactory result was obtained; trismus was relieved permitting a maximum jaw opening of 40mm. One year and 9 months after the operation, jaw movement remains at 34-40mm.
Treatment of actinomycosis, the role of interposition in arthroplasty and advantages of fascia temporalis are discussed.

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Lipoma is a benign tumor derived from nonepithelial origin and may occur almost anywhere on the body. In the oral cavity, however, lipoma is a relatively rare tumor.
In this report, 30 cases of lipomas treated in our department during past 24 years are reviewed.
1) The incidence of lipoma in our department is 4.1% of all benign tumor. Salivary gland tumors and epulis are excluded in this report.
2) 16 patients were male and 14 female.
3) Age ranged from 47-day-old baby to an 82-year-old man; mean age was 47.9 years.
4) 11 cases were in the buccal mucosa, 4 in the mucogingival junction, 3 in the retromolar pad, 3 in the tongue, etc.
5) Tumor size ranged fron 5×5mm to 50×50×40mm in the oral cavity, and from 25×25mm to 80×50mm out of the oral cavity.
6) 24 tumors were histologically diagnosed as lipoma, 5 as fibrolipoma, and 1 as angiomyolipoma.

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Pedicled graft of buccal fat pad with lyophilized porcine dermis was used for the closure of 6 cases of palatal defects due to surgery of maxillary tumors. In four cases the oroantral and/or oronasal communications were closed, and in two cases exposed bone and muscles were covered. Three of 6 cases were of squamous cell carcinoma originating from gingiva and three were of either ameloblastoma or pleomorphic adenoma.
Results of 6 cases to which this method was applied are as follows.
1. This method could be applied to large palatal defects; in our cases the maximum defect size was 60×50×30mm.
2. Epithelialization generally occurred in about two weeks in conjunction with dissolution of the lyophilized porcine dermis.
3. The epithelialized tissue possessed similar characteritics to normal palatal mucosa.
4. Epithelialization was not affected by either radiotherapy or chemotherapy.

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We describe five cases of pleomorphic adenoma occurring in buccal (2 cases) and upper lip (3 cases) mucosa.
Subjective symptoms resolved within four months with the exception of one case which lasted approximately twenty years. Differential diagnosis from the paraparotid gland was necessary to determine the origin of the tumors found in the buccal mucosa. Tumor enucleation was the procedure of choice as excision risks facial nerve and parotid gland duct injuries, and because of difficulties in setting safe surgical margin.
Infiltration of tumor cells into the capsule was noted in four cases requiring postoperative follow up; there was however no tumor recurrence for periods ranging from three to seven years and ten months.

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This article presents ia case of thyroglossal cyst. The patient, a 9 year-old boy, underwent cyst enucleation at another centre; subsequent recurence and pus discharge from two fistulae in the anterior neck developed. The tract was carefully, enucleated passing anterior to the basihyoid. The postoperative course is uneventful without recurrence.

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We recently encountered d 14-year-old male with bilateral odontomas in the lower jaw associated with unilateral mandible cyst. Odontomas and the cyst were removed under general anesthesia, the postoperative course was uneventful.
Bilateral odontomas and cystic odontoma are rarely seen, particularly together.
The bilateral odontomas appeared related to the change of general and regional conditions associated with the development of the mandibular second molars.

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Clinical and statistical observations were made of the first ten years' operations of the ward medical service started at the Department of the Dentistry and Oral Surgery in the National Nagoya Hospital.
The total number of patients was 519, 247 and 272 females. Male to female ratio was 47.6% to 52.4%. (1) Patient numbers catagorized by disease are as follows: inflammatory cases 196 (34.3%), cystic cases 96 (16.7%), neoplasms 60 (10.4%), trauma 59 (10.2%), malposition of the tooth socket 49 (8.5%), salivary gland cases 43 (7.5%), deformities 18 (3.1%), tooth extraction 13 (2.3)%, neural disease 5 (0.9%), and others 37 (6.4%). (2) Concerning age/disease distribution, approximately 34% of those under ten years old were deformity case. Older patients suffered predominately neoplastic disease. (3) Concerning age distribution the majority were in their twenties (16.8%), and then in decreasing order as follows: forties, thirties, fifties, sixties, 10-20's, and under tens. (4) Concerning distribution by regions, 96.3% of cases were from Aichi Prefecture; Nagoya City accourting for 66.3% of that figure. Accordingly, our institute has therefore fully served its designed function as a medical service institute of quality in the dental and oral surgical fields for the City of Nagoya.

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During the ten years from April, 1978 to December, 1987, the number of cases of pathological histology examination conducted at the Department of Dentistry and Oral Surgery in the National Nagoya Hospital ammounted to 610; 519 cases of disease were found. 1) The largest disease group was radicular cyst which accounted for 19.2% of all cases, followed by mucoceles (12.0%), squamous cell carcinoma (8.4%), fibroma (8.0%), periapical granuloma (6.3%), epulis (5.2%), and various others in lesser numbers. (2) The maximum number of the case of disease was radicular cyst, accounting for 20.7% of all cases of disease, followed next by the mucocele (13.0%), fibroma (8.1%), periapical granuloma (7.7%), postoperative Wangenzyste (6.3%), and others in lesser numbers.(3) The number of histological examinations for one case of disease was high in neoplastic diseases such as 3.3 cases for admantinoma, and 2.2 cases for the squamous cell carcinoma. (4) Cystic disease were by for the largest disease group accounting 39.8% for of all cases followed next by neoplasm (111 cases, 21.6%), paradentium diseases (83, 15.4%), oral mucosa cases (41, 7.9%), salivary gland cases (36, 7.0%), maxillary cases (16, 3.1%), and other cases (25, 4.8%).

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The ability of verapamil (VER), a calcium blocker, to enhance the antitumor action of adriamycin (ADR) and peplomycin (PEP) was studied in vitro. As compared with ADR treatment only, antiproliferative effects of ADR were enhanced in a human myelogenous leukemia cell line (K-562 cells) and a human squamous cell carcinoma cell line (HSC-3 cells) by simultaneous treatment with VER and ADR. Simultaneous administration of VER and PEP also enhanced the antiproliferative effects of PEP in HSC-3 cells. Moreover, in comparison with simultaneous treatment with VER and ADR in K-562 cells, the antiproliferative effects of ADR were further enhanced by one hour subsequent treatment with VER. Similar enhancement was shown in HSC-3 cells by two hours subsequent VER treatment.
However, when VER was added to HSC-3 cells for more than two hours subsequent to PEP administration, antiproliferative effect were lower than those induced by simultaneous VER and PEP treatment.
In comparison, thirty minutes pretreatment with VER decreased the antiproliferative effect of ADR in HSC-3 cells.
These results suggest that VER is able to enhance the antiproliferative effects of ADR and PEP in vitro; it appears that the time of VER administration may play an important role in the enhancement of the antiproliferative effects of ADR and PEP.

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