Normal epithelial cell line (M-SGα) has been established from mouse submandibular gland in serum-free cell culture. Although the mode of chromosome numbers of the cells shifted from diploid to triploid with increasing passage level, the cells had no tumorigenicity in athymic nude mice. M-SGα expressed some of the functional proteins which were characteristic of mouse submandibular gland ductal cells by indirect immunofluorescence antibody technique and also expressed EGF, FGF and TGFβreceptors. Proliferation of the cells was stimulated by either EGF or acidic-fibroblast growth factor (a-FGF). Furthermore, it was revealed that EGF and FGF were essential factors for the growth. Growth of the cells was inhibited by calf serum or transforming growth factor β(TGFβ). But the inhibitory activities in calf serum were destroyed by heat treatment. Therefore, it was speculated that some unknown growth inhibitor for epithelial cells which was different from TGFβexisted in calf serum.
Taken together, this cell line which was established in serum-free culture would be useful to study the growth and differentiation of normal epithelial cells.

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The static as well as dynamic analyses of natural tooth and dental implants have been conducted using a finite element method and theoretical analysis method in an effort to develop the proper suppo ting system and shock-absorbing structure for dental implants. Followings are the results.
I. Analysis of Natural Tooth
1. When periodontal ligament was assumed to be an elastic continuum, the concentration of very large stress was observed at the apex under static load condition. When an impact was applied, the stress magnitude reached about 11 times the stress under static load condition.
2. In the case of osteoankylosis, uniform diffusion of stress was observed under static load condition, but tooth mobility was poor. When an impact was given, the stress magnitude reached as high as 200 times the stress under static condition.
3. When the transmission of force along the fibers of periodontal ligament is taken into consideration, both the degree of the displacement and the natural vibration frequency corresponded to the the clinically measured values; the stress concentration in the apex eased appreciably under static load condition, and when an impact was applied the stress fluctuation remained at a comparatively low as 10-fold increase.
4. Theoretical analyses found that the viscosity level of periodontal ligament corresponds to the theoretical value where the highest shock-absorbing capability can be obtained. Due to this high viscosity, stress generated by the impact can be reduced to about 75 percent of the case when only elasticity is present.
II. Analysis of Dental Implant
1. Under static load condition, generally satisfactory results were obtained in stress diffusion by osteointegration. However, when implant material elasticity differs greatly from that of the bone, localized concentration of stress was measured at a protruding portion on the surface of implant.
2. When an impact was given, due to osteointegration the stress which is about 200 times larger than the stress under static load condition was measured.
3. In the dental implant having imbedded shock-absorbing structue, the displacement and vibration behaviors displayed by it were similar qualitatively and quantitatively to ones exhibited by natural tooth. The shock-absorbing capability also matched that of natural tooth.

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It's feared that morphologic changes of face and abnormal occlusion may occur after surgical intervention in growing mandibles. So the author experimentally studied the influence of 4 types of bony resections on rat mandible growth.
Sixty 4-week-old WKA rats were used in the study. They were divided into 6 groups as follows: Group 1. Periosteal elevation and bone resection at the inferior border of the mandibular body were performed in the left mandible. The resected bone size was φ 2.3mm. The operation procedure before bone resection in groups 2-5 was the same as in group 1. Group 2. Bone resection was performed at the same site as in group 1, but the size was φ 4.0mm. Group 3. The bone was resected at the center of the ramus; the size was φ 2.3mm. Group 4. The bone was resected at the mandibular foramen. At the same time, the inferior alveolar artery and nerve were cut. Group 5. Only periosteal elevation was performed. Group 6 (Control). These rats were sacrifiecl at 15 weeks of age and decapitated, the specimens were measured and analyzed statistically.
The resection at the inferior border of the mandibular body led to mandible growth of inhibition, mainly at the site of the mandibular angle. This inhibition was great in proportion to the size of the bone resection. The bone resection at the inferior border of the mandibular body led to greater growth inhibition than the bone resection at the center of the ramus. The bone resection at the mandibular foramen led to great mandibular growth inhibition.

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Bone defects in the growing period give rise to mandibular growth obstruction. After the bone is resected, the defect in the mandible is reconstructed by means of bone graft or ceramic implantation to maintain mandible form and function, but the effect on mandibular growth has not been studied in detail. So the author has studied experimentally the effects of bone graft and the implantation of 2 types of ceramics, hydroxylapatite (HA) and tricarcium phosphate (TCP), in surgically caused mandible defects growth.
Ninety-six 4-week-old WKA rats were used in this study. Of these 36 rats were used for histological study and 60 were divided equally into the 6 following groups: Group 1. Bone was grafted into the defect at the mandibular body inferior border. Group 2. Bone was grafted into the defect at the mandibular ramus center. Group 3. Fibrin adhesion system (Tisseel ^® kit) was filled into the bone defect created the same as in group 1. Group 4. Bone was grafted with fibrin adhesion system into the bone defect created the same as in group 1. Group 5. HA was implanted with fibrin adhesion system into the bone defect created the same as in group 1. Group 6. TCP was implanted with fibrin adhesion system into the defect created the same as in group 1. Sixty of the rats were sacrified at 15 weeks of age, decapitated, and the obtained specimens were evaluated by measurement, contact microradiography and radiography.
Growth inhibition of the mandible after resection of the mandible inferior border was significantly improved by replantation of the removed bone itself to the resected site, but there was no significant effect on mandible growth when the defect at the mandibular ramus center was filled with bone. Ceramics implantation into the defect of the mandible inferior border showed a similar but not significant effect to that seen in the case of bone replantation.

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Isolation of herpes simplex virus (HSV) in cell culture, in parallel with neutralizing (NT) antibody assay in paired sera, was carried out in specimens collected from oral lesions of 73 outpatients with clinical signs of HSV infection at the Department of Oral Surgery, Yokohama City University Hospital.
Of 47 samples collected within 4 days of outbreak of symptoms, 34 were positive for HSV, but isolation rate decreased gradually depending on time of sample collection and reached 20% in samples taken after 12 days. In general the virus was isolated more easily from primary cases than from cases of recurrence.
Clinically, ulcer was predominant (53%) in primary cases, and scattered vesicles were more commonly observed (49%) in recurrence. This difference seems to reflect the histological characteristics of the regions, i.e., mucous membrane and skin, where these infections tend to appear. NT-antibody in primary cases was first detectable 3 to 9 days after onset, and reached a maximum and plateau level in 2 to 3 weeks. On the other hand, antibody titer was not different in either acute or convalescent phase in most of the recurrent cases.
From our experience we concluded that the collection of specimens from lesions should be done as soon as possible after onset of clinical manifestations to get successful results in isolation, and sera should be collected within 7 days of onset of illness for the acute phase and after 14 days for the convalescent phase to identify primary infection from recurrence by means of NT antibody titers.

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A fibronectin-producing cell line, called NA cell, has been established from explant culture of a primary squamous cell carcinoma of the tongue. Continuously propagated over 400 passages, NA cell shows a polygonal shape and monolayer growth. Morphological examination revealed the cell as having epithelial and malignant characteristics. The population doubling time of NA cell is approximately 21. 6 hours. The cell cycle was analyzed by means of a pulse-labeling-chasing method, showing a 15-hour cell generation time consisting of 6. 3 hours G₁ period, 4. 5 hours S period and 4. 2 hours G₂ period. The cells were implanted in BALB/C-nu/nu nude mice and histopathological findings of the implanted tumor resembled the original structure. Ultrastructural observation of the implanted tumor revealed presence of desmosornal attachments between cells and cytoplasmic tonofilaments. In karyotype analysis, the patterns of chromosomal distribution were mostly hypertriploid, mode 76.
The location of fibronectin was investigated with an avidin-biotin complex immunoperoxidase technique (ABC), revealing fibronectin distributed on the cell surface and in the cytoplasm around the nuclei. The synthesis of fibronectin was then examined by an enzyme-linked immunosorbent assay (ELISA), revealing an increase of fibronectin in the conditioned media in a time-dependent manner until the cell reached the stationary phase.
As these data indicate that this cell line produces fibronectin, NA cells may be useful for studying mechanisms of metastasis and invasion of tongue cancer.

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The energy metabolism of human malignant melanoma from gingiva into nude mouse (HMG tumor) was studied by a ³¹P-NMR spectroscopy. The spectra of HMG tumor showed peaks of phosphomonoester, inorganic phosphate, phosphodiester, phosphocreatine, γ-phosphate of adenosine 5'-triphosphate, α-phosphate of adenosine 5'-triphosphate and βphosphate of adenosine 5'-triphosphate. Phosphomonoester and adenosine 5'-triphosphate were high.
Phosphomonoester, adenosine 5'-triphosphate and phosphocreatine decreased and inorganic phosphate increased after i.p. injection of pepleomycin. However, there were no observable changes in the spectra of muscle.
The results suggested that ³¹P-NMR spectroscopy was valuable to investigate the energy metabolism in tumor tissue and to evaluate the effects of chemotherapy.

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Subrenal capsule assay (SRC assay) was initially developed by Bogden et al. and has been reported to be an effective method for predicting the sensitivity of individual tumor patients to anticancer agents. However, there still remains some inherent problems such as influence of the host immune responses, drug doses, and methods of administration.
Meanwhile, combination chemotherapy has mainly been performed recently against human malignant tumors in the oral region. cis-diamminedichloroplatinum (CDDP) and peplomycin (PEP), which are effective agents against squamous cell carcinomas, have clinically exhibited a combined efficacy.
Despite the observances made in basic experiments as well as clinical trials, single agent chemosensitivity is mainly examined in the study of SRC assay, and few studies were reported as for combination chemotherapy.
Experimental studies, therefore, were made to examine the possibility of combination chemotherapy using CDDP and PEP in SRC assays.
In animals pretreated with minute immunosuppressive doses of X-ray irradiation which had been administered 24 hours prior to tumor implantation, when CDDP was administered before PEP treatment, the combination effect was more pronounced than when CDDP was administered after PEP treatment. Marked inhibition of tumor growth was shown especially when CDDP was administered 24 hours before PEP treatment.
As results of the foregoing studies, SRC assay was acceptable as an experimental model for predicting a combination effect of CDDP and PEP, and recognized that it may provide an important information in the choice of combination chemotherapy.

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Recently, hydroxyapatite which is made from apatite hydroxide has been clinically used in dental implants. It is known that hydroxyapatite functions as osteoconduction but not as osteoinduction. Thus, we applied demineralized dentin, a material having an effect of osteoinduction, in combination with hydroxyapatite dental implants. The author observed morphologically its mechanism in relation to bone attachment. Thirty mongrel dogs were used in this study. Their 3rd and 4th premolar teeth were extracted. After extraction, the teeth were cleaned by removal of the dental pulp and remnants of periodontal ligaments which remained on the cement surface. The extracted teeth were decalcified using Plank-Richlo method for 1 week, and rinsed overnight with distilled running water then sliced 100μm thick in a cryostat. The sliced dentins were implanted with Apaceram ^®. At 3 days, 1 and, 2 weeks, 1, 3 and 6 months after operation, the experimental dogs were sacrificed and specimens were fixed. The osteoid was observed around the demineralized dentin 3 days after operation. On days 7 and 14 after operation, new bone accumulated around the implant. On day 7, the demineralized dentin was enclosed by new bone. On day 30, demineralized dentin was resorbed and replaced by new bone with the passage of time. The newly formed bone was found to be ankylosed with the implant.

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We implanted a glass ceramic dental root implant into the mandible of an adult dog two months after extraction, prepared specimens 5 days to 420 days after implantation, and histologically examined the reaction between glass ceramic and the mandibular tissue with an optical microscope. The result showed that the implant and compact bone were closely attached in the compact bone region 15 days after implantation.
We recognized a new bone formation along the implant surface and also numerous osteocytes, 15 days after implantation.
We found osteoclasts and a bone resorption image in a part of the bone attached to the implant 30 days after implantation. The resorption image, however, almost disappeared and the implant and compact bone completely ankylosed 60 days after implantation. The bone recovered its original structure 90 days after implantation. There were no changes in osteo-ankylosis of the implant and the bone 420 days after implantation.
In the spongy bone region, a new bone beam was formed from the surrounding osseous tissue toward the implant, a part of which attached to the implant from 5 days to 10 days after implantation.
We saw a new bone formation along the implant surface from 10 to 15 days after implantation.
The bone increases in width showing a network structure near the implant surface and attached to the implant 30 days after implantation. The new bone formed on the implant surface increased in thickness and ankylosed to the implant 60 days after implantation.
The bone beam decreased in number and shifted to the original spongy bone appearance while the medullary cavity expanded 90 days after implantation.
The osseous tissue was formed in nearly the whole implant surface area and the osteo-ankylotic condition of the implant to the spongy bone was satisfactory 150 days after implantation.
Further, there was no remarkable change in the condition until 420 days after implantation.
The result of this experiment confirmed that a glass ceramic has a high tissue affinity or osseous tissues around the implant with an excellent osteo-ankylotic condition of the glass ceramic to osseous tissues. Thus, we confirmed that it is an applicable material for implants.

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In recent years, corrective surgery for jaw deformity has been performed much more frequently and since facial improvement is one of the goals of orthognathic surgery there is increasing need for better methods of rapid and accurate cephalometric analysis and prediction of the results of orthognathic surgery. The authors developed a computer aided cephalometric analysis and profile prediction system for orthognathic surgery of mandibular prognathism which is a common jaw deformity in Japan.
This system consists of personal computer, color graphic display, digitizer, graphic plotter and printer, and has six functions as follows:
1) Input and storage of the data from lateral cephalogram.
2) Hard-tissue structure analysis by Downs-Northwestern method (20 measurement items).
3) Soft-tissue profile analysis by Legan-Burstone, Ricketts, and Merrifield (14 measurement items).
4) Prediction of soft tissue profile as a result of mandibular set back.
5) Soft-tissue profile analysis of predicted profile.
6) Computer graphic illustration of the existing pre-, and post surgical profiles and predicted profile.
Prediction of the post surgical profile, which is the main function of this system, can be carried out immediately after digitization of the hard tissue landmarks located on the anterior mandible which are moved to a position to make good interincisal relationship and stable occlusion with reference to model surgery. The predicting equations were derived from stepwise multiple regression analysis on the basis of the 40 sets of pre-and post surgical lateral cephalograms of mandibular prognathic patients operated by mandibular set back. The suggested advantages of this system are as follows:
1) Cephalometric analysis of hard and soft tissue profiles and the profile prediction can be carried out rapidly, easily and accurately.
2) Post surgical profile is predicted by multiple regression equations for each coordinate of each landmark, since the post surgical profile is the result of the interaction of many variablesrather than simple one-to-one variable relationship.
3) The profile line is drawn by computer graphics as a line passing the predicted soft tissue landmarks and therefore no artistic skill is required.

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Three monoclonal antibodies (MoAb), 1 F 9, 1 G 5 and 3 B 4, were produced by fusion of spleen cells of a BALB/c mouse immunized with Ca 9-22 cell from human squamous cell carcinoma of gingiva and murine myeloma cells SP 2/o.They were screened by 51Cr release assay of complement dependent cytotoxicity.Their isotypes were all IgM which recognized the cell surface antigens.Five MoAbs, 1 B 11, N 2, N 4, N 18 and 4 B 3, were prepared against NA cell from human tongue squamous cell carcinoma by the same procedure, but they were screened by radioimmunoassay using 125I-protein A.All MoAbs had isotypes IgG and only four recognized their antigen in the cytoplasm.N 4 recognized the antigen existing in both cytoplasm and cell membrane.
The reactivity of each MoAb to various cells and tissues was analyzed by immunostaining method.They were separable into three groups by the cell specificity, i.e.the first group including 1 F 9, 1 G 5, and 4 B 3 reacted to all squamous cell carcinoma cells tested but not to the normal diploid fibroblast WI 38.The second group comprising of 1 B 11, N 2, N 4 and N 18 was reactable to both squamous cell carcinoma cells and WI 38.The third group of 3 B 4 reacted to only Ca 9-22 used as the immunogen.From the study using paraffin embedded tissues including oral cancers and normal tissues, it was revealed that 1 F 9 and 1 G 5 stained the cell membrane of the cancer nest in squamous cell carcinoma and the prickle cell layer in the oral mucosa.The second group of MoAb, 1 B 11, N 2, N 4 and N 18, stained both parenchymal and stroma cells simultaneously.3 B 4, interestingly, showed different reactivity between individuals, namely in a positive case it stained not only the normal and malignant cell of squamous epithelial origin but also endothelial cells and erythrocytes in the stroma.However, in a negative case it did not stain any type of cell, suggesting that 3 B 4 may recognize an antigen related to the blood group.

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In order to study the mechanisms of bone resorption induced by squamous cell carcinoma (SCC), the author analyzed bone resorbing substances released into the medium by an established SCC cell line Ca 9-22 PF. This cell line was derived from human gingival SCC and cultured in a protein-free medium. The analysis of bone resorption was carried out by the measurement of released ⁴⁵Ca from pre-labeled mouse calvariae.
The results were as follows:
1) A dose dependent stimulation of bone resorbing activity was found by adding the cultured supernatant of Ca 9-22 PF cells.
2) The bone resorption was due to the formation and activation of osteoclasts, because the stimulation was found only in live calvariae and was reduced by calcitonin treatment.
3) About half of the ⁴⁵Ca release stimulating effect was inhibited by indomethacin, an inhibitor of prostaglandin production.
4) When the conditioned medium was fractionated by gel chromatography, the bone resorbing activity was found in multiple fractions. The molecular size in each fraction having a bone resorbing activity was 12000-16000, 16000-20000, 35000 and larger than 50000, respectively.
5) The bone resorbing substance having the MW 12000-16000 was identified as IL-la by a specific radioimmunoassay and neutralization by antibody.
6) The substance having the MW 16000-20000 was identified as PTHrP by stimulation of cAMP production in ROS 17/2 cells and by the Northern blot hybridization.
7) The substance having the MW 35000 was identified as PDGF-AA by stimulation of proliferation in BALB 3 T 3 fibroblasts and neutralization by antibody.
8) In addition to IL-1α, IL-1 β, PTHrP and PDGF-AA, the substances responsible for the stimulated bone resorption were identified as TGFα and TGFβ by the Northern blot analysis.
9) The conditioned media of other SCC cell lines, HSC-2 PF, HSC-3 PF, HSC-4 PF, A 431 PF and ZAPF, also showed bone resorbing activity similar to Ca 9-22 PF. Bone resorbing factors were also identified to be about the same as those produced in Ca 9-22 PF by the Northern blot hybridization.
In conclusion, it was speculated that the synergistic action of these substances produced by SCC are responsible for a marked increase in osteoclastic bone resorption and malignancy associated hypercalcemia.

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A case of cystic lymphangioma was recently encountered in which a buccal swelling had remitted on centesis and aspiration without any definitive diagnosis at the age of 2 years and recurred when the patient was 10 years old. Exploratory incision made under the clinical diagnosis of hemangioma disclosed the lesion to be cystic lymphangioma. Surgical treatment was performed by excision as extensively as feasible and the patient has been progressing favorably with no indications of recurrence five years. The case will be reported with a brief review of the literature.

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We reported here a case of Lymphoepithelial cyst arising at the ventral surface of the tongue in a 34 year old male.
Histopathological examination revealed that the cyst was composed of fibrous tissue, thin squamous epithelium and lymphoid tissue with a prominent germinal center. This case was considered to be a typical, oral lymphoepithelial cyst.
We also examined the distribution of immunoglobulins, T and B cells and lysozyme.
Immunohistological examination revealed that immunoglobulin-positive cells (IgG, IgA and IgM) were distributed between the lining epithelium and lymphoid tissue with a variation in number. Localization of lysozyme-positive cells was similar to that of immunoglobulin-positive cells. Similar to tonsil and lymph node, B cells were observed in the cap area and medulla of lymphoid tissue while decreased numbers of T cells were found in fibrous connective tissue beneath the lining epithelium.

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We made a clinico-statistical observation of 100 cases of benign tumor patients who had been examined during the 11 years from April, 1978 to December, 1988 at the Department of Dentistry and Oral Surgery, Nagoya National Hospital.
1) The ratio of odontogenic tumors to non-odontogenic tumors to salivary gland tumors was 1: 10. 3: 1. 3, indicating that the majority were non-odontogenic tumors. The ratio of male to female was 1: 1. 8, indicating female was higher than male.
2) By histological classification there were 5 cases of ameloblastoma, 2 of cementoma and 1 of odontogenic myxoma in odontogenic tumors, 52 of fibroma, 14 of hemangioma, 6 of papilloma, 6 of lymphagioma and 4 of steatoma in non-odontogenic tumors, and 10 of plemorphia adenoma in salivary gland tumors.
3) By the presumptive age group at the primary manifestation, the majority were in the 30 s and 40 s, and the average age was 35. 9 years. In odontogenic tumors there were patients in the teens and the 30 s, and the average age was 29. 8 years. In non-odontogenic tumors there were more patients in the 30 s and 50 s, and the average age was 38. 7 years. In salivary gland tumors there were more patients in the teens and 40 s the average age being 39. 3 years.
4) By the age group at the primary examination there were more patients in the 60 s, 50 s, and 30 s, the average age being 39. 8 years. In odontogenic tumors, the majority were in the 30 s and the average age was 37. 8 years. In non-odontogenic tumors, there were more patients in the 60 s, 50 s, and 30 s, the average age being 42. 5 years. In salivary gland tumors, the majority were in the 40 s, the average age being 43. 1 years.
5) The affected period ranged from 1 month to 3 months in most cases. The affected period was from 1 year to 3 years in non-odontogenic tumors, and it was from 1-3 months in the majority of salivary gland tumors.
6) Chief complaints were swelling and oncogenesis, accounting for 85 cases (84.2%), followed by 7 cases (6.9%) of incongruity feeling and 6 cases (5.9%) of pain in this order.
7) By manifestation site the tongue was most frequently was affected accounting for 26.0%, followed by gum in 18.0%, palate in 14.0%, and lips in 14.0%. With regard to the odontogenic tumors, they appeared only in the maxilla and the mandible. The salivary gland tumors mostly appeared in the palate and parotid gland regions.
8) By dimensions, 33 cases were from 5 to less than 10mm (33.0%), followed by 28 cases from 10 to less than 20mm (28.0%) and 16 cases from 20 to less than 40mm (16.0%).
9) For therapy all were treated by excision or extraction except in 2 adamantinoma cases in which excision of the maxillary bone was conducted.

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We encountered and reported a case of squamous odontogenic tumor that developed in the gingiva of the lower third molar of a 51-ear old woman. This case may be the first of this kind of tumor ever reported in Japan. The chief complaints were gingival bleeding and painless swelling. The tumor was nodular, firm and located distal to the gingiva of the lower third molar. It was a tumor in size of the tip of the small finger, presenting the color of healthy gingiva. Radiographically, a horizontal type bone absorption was noted around the molar. As for the treatment, extraction of the molar and local excision of the tumor were performed. Histologically, numerous islands large and small consisting of well differentiated squamous epithelium were observed. The stroma was composed of mature fibrous collagenous connective tissue. The periphery of the islands was flattened or cuboidal but mostly flattened and showed no epithelial columnar cells. The presence of vacuolization and/or microcyst formation was observed in the islands and acidophilic substances were found in the microcyst formation. Prognostic observations were made for two years and six months during which no recurrence was noted. As to the development of this tumor, a theory that it is derived from Malassez epithelial remnant is widely accepted. However, we have presented a view againt this theory. In our view, it is possible that a weak dental lamina of the permanent teeth or the lateral enamel strand prior to formation of ameloblast remains in the jaw bone and/or paradentium and later developes into a tumor.

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If a portion of the muscle for mastication is affected by localized, continuous deterioration of muscle tone, metabolic disturbance caused by localized anemia causes pain. In turn, this pain, causes neuralgic dysfunction and abnormal jaw movement: a condition known as myofascial pain dysfunction syndrome (MPD syndrome).
The authors measured the skin surface temperature in the area of the temporomandibular joint of patients suffering from MPD syndrome and compared the skin surface temperature rise on both affected and healthy sides after exercising the jaw. We found that the temperature rise rate of the healthy side was greater than that of the affected side. But after treatment temperature rise rate differences between the affected and healthy sides lessened.
Acupuncture of the meridian point of “Gekan” has been used to treat the inferior articulator of the patients. Instead of using needle, the authors irradiated the inferior articulator several times with a low power laser (Nd: YAG at 350 mW). This relieved the pain somewhat, but since the treatment's results were evaluated by the subjective judgement of the patient alone, the authors used thermography to make an objective evaluation of symptomatic changes with the result reported in this article.

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Angioneurotic edema, so called Quincke's edema, is a disease characteristic of suddenly appeared localised noninflamatory swelling of the skin or mucous membrane.
We report 5 cases of Quincke's edema which we experienced in the last three years. These were a 26 year old woman (case 1), a 48 year old man (case 2), a 30 year old man (case 3), a 39 year old woman (case 4) and a 79 year old woman (case 5). 3 cases (1, 3, 4) were treated by an antihistamic agent, one of them in combination with epinephrine. 2 cases (2, 5) had reccurrent attacks which lasted from hours to day. As none of them had a family hitory, they were assumed non-hereditary angioneurotic edema.
Finally our 5 cases and 45 cases which had been reported in Japan since 1955 were discussed.

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Cat scratch disease in the submental region of a 62-year-old man was reported. The patient was scratched on the mental region by his domestic cat about two weeks befbre a swelling in the submental region was noted. About thrcc weeks later, he visited our clinic complaning of submental mass mesurcd 40×40×10mm. Five lymph nodes were removed by enucleation. We made the diagnosis of cat scratch disease by clinical and histopathological findings.

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The pectoralis major musculocutaneous flap (PMMC-flap) has been used for the immediate reconstruction of defects in thc head and neck region. This technique is highly valued because it can transplant a large amount of well-vascularized tissue, but its vascular pattern seems to have been characterized by a simple axial pattern without adequate investigation.
Recently, the vascular anatomy has been clarified gradually as many authors have reported on it in detail. The purpose of this study was to define the vascular pattern of the PMMCflap by dye injection, angiography and cadaver dissection.
Materials and methods:
Dye injection: Fresh cadavers (3 males, 2 females), were used and different color inks were injected in to the internal thoracic artery and thoracoacrominal artery. Then the colored skin areas on the chest were observed and recorded. Angiography: Fresh cadavers (3 males, 7 females) were also used into which a contrast medium was infused via the femoral artery, and the pectoralis major muscle and overlying skin with adjacent vessels were resected. After taking X-ray photographs and making the angiograms, the vascular patterns in the muscle and cutaneous layer were analysed. Subsequently the PMMC-flap on the cadavers was evaluated and the vascular pattern was analysed from the angiograms.
Cadaver dissection: The vascular anatomy was studied by cadaver dissection.
Results:
1) The pectoralis major muscle and the overlying skin were found to receive their blood supply from separate blood vessels.
2) The musculocutaneous perforators directly airisng from the dominant artery appeared in certain limited areas only and not observed in the area where the skin island is usually designed.
3) The blood supply of the PMMC-flap was supported by a communicating circulatory system from the muscle to cutaneous layer, which was formed by the pectoral branch anastomosing with the anterior perforators in the muscle and fascial layer.
4) It seems that the vascular pattern of the PMMC-flap is not of axial pattern directly sustained by musculocutaneous perforators arising from the pectoral branch but is of extended axial pattern which is spreaded in three dimensions by anastomosis to adjacent vessels.
5) The concept of this vascular pattern is very important and the author thinks that with this knowledge we can reduce the risk of partial and/or marginal necrosis in the skin island on the PMMC-flap.

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Granular cell tumor is a relatively rare soft tissue benign tumor. In this paper, a case report of the tumor occurring in the tongue of a 44-year-old man is presented. The histology was confirmed to that in Abrikossoff's classic description of the tumor. The patient was treated surgically and was well months later. Immunohistochemical and electron microscopic observations revealed that this tumor was strongly suggestive of peripheral nerve origin as reported by other investigators.

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Recently serious odontogenic infections have decreased because of improved chemotherapy. However, it is difficult to control if patient's defenses are compromised by such as DM.
A 65-year-old female was referred to our hospital with swelling in the left neck and dyspnea. The lesions were diagnosed as oral floor phlegmone and mediastinitis caused by odontogenic infection of the lower second molar. She was also diagnosed as latent DM. In spite of surgical treatment and chemotherapy for detected anaerobes along with insulin treatment for DM, she died one month after the admission.
In such a case it is nesessary to control DM, to select effective antibiotics after frequent examinations of bacteria and to perform proper surgical treatment.

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The lipoma is a rare intraoral tumor, although it occurs almost anywhere on the body. We reported clinico-pathological examination in 15 cases of lipoma and 2 cases of lipoma like lesion (herniation of buccal fat pad) during the past 28 years and 7 months from January 1961 to July 1989. 15 cases of lipoma were separated 10 cases of superficial type from 5 cases of diffuse type. 15 cases of lipoma were clinico-pathologicaly similar to those described in the past reports. Results obtained were as follows: 1) The lipoma patient age ranged from 19 to 70 years and the average age was 53. 1 years. On the other hand the age of herniation of buccal fat pad patient was infant in 2 cases. 2) In lipoma, 8 cases were male and 7 cases were female. Both herniation of buccal fat pad cases were female. 3) Lipoma in 6 cases appeared in the buccal mucosa, 3 in the tongue, 3 in the lip, in the oral floor, and in the mucogingival junction. 4) The duration of symptoms in lipoma ranged from 5 days to 16 years, but on the other hand the duration of symptoms in herniation of buccal fat pad ranged from 3 days to 2 days. 5) The average size of lipoma and herniation of buccal fat pad was both about 20 mm in diameter. 6) Superficial type of lipoma which was yellowish, and pedunclated with a clear border was more easily diagnosed than diffuse type of lipoma which was normal mucosa color and had a vague border. 7) 12 tumors were histologically diagnosed as lipoma, 3 as fibrolipoma.

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A patient with oral-facial-digital (OFD) syndrome is reported. The patient was a 5-year-old female who had a tumor of the tongue, fistula of the lower lip, and abnormal frenulum that were treated surgically. OFD is, rare hereditary disease that is classified as OFD I or II by the pattern of inheritance and the clinical features. Our patient was diagnosed as OFD I. In Japan, there have been few reports dealing with this syndrome.
Most cases in Japan have the features of bifid tongue and/or tumor of the tongue, abnormal frenula of the lips, cleft alveolar cavities, coarse or friable hair, hypertelorism, and an abnormal nose as well as clinodactyly and/or syndactyly.

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We reported a case of pycnodysostosis and review of 67 cases in the Japanese literature, especially on its oral and maxillofacial aspects. The following oral and maxillofacial findings were commonly reported in most cases: 1. mandibular angle loss, 2. hypoplasia of the maxilla and mandible, 3. grooved palate and 4. malpositioned teeth. Other findings reported occasionally included: osteomyelitis, anterior cross bite, mandibular fracture, permanent tooth missing, hypercementosis, microdontia, delayed eruption of permanent tooth, persistence of deciduous tooth, enamel hypoplasia, obliterated pulp chamber, macroglossia, hypoplasia of dental root and dentin hypoplasia.

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A myxoid tumor of the jaws is a relatively rare disease. The origin and history of development of this tumor is controversial and as yet there is no established theory of pathogenesis. A swelling of the right maxilla in a 26-year-old female was noted on examination. The diagnosis from histopathology was myxofibroma. The maxillary sinus was filled with tumor. Treatments included subtotal resection of the maxilla and the insertion of a maxillary prosthesis. The patient is currently four year status post resection with no recurrence. The overall prognosis is favorable.

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Eosinophilic granuloma has been designated as Histocytosis X together with Hand-Schilller-Christian and Letterer-Siwe diseases. It is a relatively rare disease of the jaw.
We reported on a 37-year-old man who had multiple eosinophilic granulomas of the mandible, maxilla, ischium and lungs.
Removal of the tumors from the mandible, maxilla, and ischium was performed surgically under general anesthesia, while the lungs were treated with a puncture biopsy. The pathological diagnosis was eosinophilic granuloma in all lesions.
The patient shows no evidence of recurrence 5 years after surgery. Thirty-one cases of eosinophilic granuloma of the jaw reported in the Japanese literature were reviewed and the present case was comparatively discussed.

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This report evaluates a variety of dental materials with respect to MR imaging artifacts in vitro. The increasing use of MR imaging as a clinical method necessitates a study of artifacts that may appear on these images. A wide variety of metallic materials are used in the dentistry and some can potentially cause distortion of MR images.
MR imaging was performed using a superconductive magnetom of 1. 5 Tesra (Magnetom; Simens).
Imaging was obtained with the use of a single 4-mm thick slice two-dimensional Fourier transform rapid technique.
Pulse sequence was obtained by Flash method at flip angle=90, echo delay (TE)=10 ms, repetition time (TR)=400 ms.
The following results were obtained;
1) Titanium, gold and high nickel content dental materials produced no discernible artifacts.
2) Stainless steel alloys caused major imaging artifacts.

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This paper describes a case of Warthin's tumor of the right parotid gland associated with sialolithiasis of the right submandibular gland.
At the same time a review of literature on Warthin's tumor of the parotid gland was briefly carried out from the aspects of clinical features, pathological and immunohistochemical findings, genesis, diagnosis, treatment, and prognosis.
The lesions were removed surgically under clinical diagnosis of sialolithiasis of the right submandibular gland and benign tumor of the right parotid gland. No complications from the operation were observed, and there were no signs of recurrence about 2 years and 10 months after the operation.
The excised specimens were examined histopathologically and immunohistochemically. The Warthin's tumor of the right parotid gland showed irnmunohistochemically that keratin and lactoferrin were positive in the tall columnar cells facing the luminal portions, while S-100 protein was positively found in several cells in the lymphoid components. CEA, lysozyme and secretory component showed no reactivities in any portions of the tumor tissue.

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