Herpes simplex virus (HSV)-human oral mucosa interaction was investigated using cultured cells and organ cultures. Epithelial cells and fibroblasts derived from human oral mucosa and mucosa tissues were infected with HSV in vitro and the expression of HSV antigen was examined by immunofluorescent antibody technique. Cultured epithelial cells and fibroblasts showed degenerative change in 24 hours after infection and HSV antigen was demonstrated in almost all of the cells. On the other hand, in organ cultures, examined 3 days post infection, the appearance of HSV antigen was confined to the undifferentiated epithelial cells of the basal cell layer and lower prickle cell layer. Neither differentiated epithelial cells nor fibroblasts in the subepithelial connective tissue showed HSV antigen. When the epithelial cells freshly dissociated from epithelium by trypsin treatment were infected with HSV and were cultured for 3 days, viral antigen was detected in 3.0-17.1% of the cells. Double-irru-nunostaining of these epithelial cells revealed that laminin-positive cells showed HSV antigen, whereas HSV antigen was not found in the cells containing highmolecular-weight keratin.
These findings indicate that differentiation state of the epithelial cells plays an important role in the appearance of HSV antigen and that once grown in the in vitro culture system, fibroblasts in the subepithelial connective tissue will allow HSV replication.

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Rat buccal skin, to which a 9, 10-dimethy1-1, 2-benzanthracene acetone solution was applied, has been examined by various immunohistochemical techniques in order to elucidate a tumoral malignancy by examining the cellular kinetics and the lectin binding. The cellular kinetics were evaluated by identifying the DNA synthetic cells (S phase cells) by using 5-bromodeoxyuridine (BrdU) and the binding by the cells to 4 different lectins, such as the PNA, WGA, UEA-1 and RCA-1 during the process of carcinogenesis.
The labeling index (LI) for BrdU amounted to 4.1% in normal epithelium, 15.2% in hyperplastic epithelium, and 17.8% in atypical epithelium. The higher the epithelial dysplasia degree, the higher the LI. Reflecting this, the LI was found to be 25.0% in a well differentiated squamous cell carcinoma (SCC) and 25.5% in a poorly differentiated carcinoma. There was no correlation, however, between the degree of the cell differentiation and the LI. BrdU-positive cells were found localized in the basal cell layer in both normal and hyperplastic epithelium, whereas they were distributed from the basal layer to the prickle cell layer in atypical epithelium.
It was found that the binding of the tumor cells to the PNA, WGA and UEA-1 differed during the process of carcinogenesis. PNA and UEA-1, for instance, were negative in areas where BrdU-positive cells were present in normal and in hyperplastic epithelium, but were strongly positive in the cells of the lower portion of the prickle cell layer and in some areas of the basal cell layer in SCC. PNA also was positive in some BrdU-positive cells.
These results indicate that evaluating the cell kinetics by using this BrdU technique and investigating the lectin binding may serve as a useful parameter in gauging a tumoral malignancy and reaching a diagnosis.

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In this study, a new bone resorption model was developed by using living bone substrates prepared from mice calvaria. Devitalized bones made by freezing and thawing of living bones as well as dead cortical bone slices of monkey femur were also used as substrates for isolated osteoclasts to act upon. The extent of bone resorption was assessed by measuring both the area and the depth of resorption pits. Recombinant Human Tissue Inhibitor of Metalloproteinases (TIMP) and Cysteine-Proteinase Inhibitor (E-64) were used to find out the different mode and extent of resorption by isolated osteoclasts between living and devitalized bones. Transforming Growth Factor-α(TGF-α) was applied to this model to investigate the possible mechanisms involved in bone resorption induced by tumors.
Both the area and the depth of pits made on living bones were more extended compared to those of pits made on devitalized bone substrates. TIMP (100μ/ml) reduced the resorption of living bone both in the area and in the depth to the same amount of resorption made on devitalized bone. But, TIMP did not inhibit the resorption of devitalized bone. E-64 (60μM) significantly inhibited the resorption of devitalized bones by 66%, while it had no effect on the resorption of living bone. TGF-α(100 ng/ml) did not show significant effect on the resorption of any substrate, but appeared to inhibit the osteoclast activity slightly (p<0.1). Indomethacin (100 ng/ml) reduced the resorption of living bone to the same level of that of devitalized bone, but did not, however, inhibit the resorption of devitalized bone. These results suggest that:
1 The resorption of living bone appeared to be aided by osteocyte-synthesis of metalloproteinases, among them collagenase, to degrade bone collagen.
2. The excess of resorption of living bone compared to that of devitalized bone also depended on prostaglandin synthesis by living cells, interior to the substrate.
3. Thus, the mechanisms of resorption underlying living bone and devitalized bone are different.
4 TGF-α(100 ng/ml) appeared to inhibit the activity of isolated osteoclast, but not significant (13, 1, 0.1). So, the stimulation of bone resorption by this factor observed in vivo may be caused first by living cells other than osteoclast.
5. This new culture system of isolated osteoclasts using living bone substrate presents a useful model for the study of bone resorption.

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A study was made of the mechanical behavior of the temporomandibular joint under occlusal force using finite element method. A two dimensional numerical model of teeth, mandible, articular disk and temporal bone was divided by 394 triangular elements and 250 nodal points. Loading conditions were expressed as a resultant force of masseter, pterygoid medialis and temporalis under various proportions of loading conditions. To evaluate lack of teeth effects on temporomandibular joint, various supporting conditions were changed.
It was suggested that the posterior band of the articular disk between articular surface of mandibular fossa and condyle functioned as the temporomandibular joint shock absorber.

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The mechanical properties and biocompatibility of zirconia dispersed hydroxyapatite ceramic (HAP-ZrO₂) were examined. The composition of HAP-ZrO₂ was 50 Vol% hydroxyapatite and 50 Vol% zirconia.
1. Mechanical properties.
Bending strength, Young's modulus and fracture toughness of HAP-ZrO₂ were 270 MPa, 60 GPa, 4.5 MPa·m^1/2 respectively.
Compared with other bioactive ceramics, such as tricalcium phosphate (TCP), hydroxyapatite ceramic (HAP) and apatite-wollastonite-whitlokite glass ceramic (A-NV-CP GC), these values showed the HAP-ZrO₂, had high mechanical strength and low Young's modulus which was close to those of human cortical bone and tooth.
2. Biocompatibility in vitro.
By using L-929 cells, the HAP-ZrO₂ and HAP cell adhesiveness experiements and cell growth were evaluated.
HAP-ZrO₂ and HAP showed no cytotoxity to L-929 cells. There were no significant differences between both ceramics concerning initial cell attachment and cell growth rate. Morphological changes of the cells on both materials observed by scanning electron microscopy also showed excellent biocompatibility of HAP-ZrO₂ and HAP.
3. The biocompatibility in vivo.
HAP-ZrO₂ and HAP were implanted into femurs of 10 week old male rats of an inbred Wistar strain. These rats were killed 1, 2, 4, 8, 12 weeks after implantation. Undecalcified ground sections were examined by light microscopy, contact microradiography and scanning electron microscopy.
Both ceramics were in direct contact with newly formed bone and there was no fibrous connective tissue at the interface. Mode and rate of bone formation were quite similar in both ceramics.
Because of its high bending strength and fracture toughness low Young's modulus and excellent biocompatibility, HAP-ZrO₂ seems to be one of the most useful substitute materials for bone and tooth.

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It is known that a peculiar sound is produced when metallic or plastic material is cracked. This sound, caused by elastic waves generated by the release of strain energy stored in a solid during its plastic deformation, is called acoustic emission. Since acoustic emission is composed of elastic waves, an initial fracture point can be determined by measurement of the lag in elastic wave arrival time. Also the amount of energy released at the time of cracking of a solid object can be calculated by application of the destruction theory of Griffith which specifies the amount of energy released as the function of cracking area.
Thus precise quantitative analysis of the cracking phenomenon of solid material is possible by means of acoustic emission measurement. However, acoustic emission in biological materials has so far been little studied. Perceiving the usefulness of acoustic emission in biological materials, the author attempted to examine the mechanism of bone fracture by detecting the initial point of fracture and calculating the amount of energy released. The experimental material consisted of a humerus, radius, femur, and tibia from a 3-year-old mongrel dog weighting 16 kg, and theedentulous mandible from an Indo-European male of estimated 60 years age. The materials were subjected to a three-point bending test. The acoustic emission in this test was picked up by acoustic emission sensors (s 9220, Physical Acoustic Co.), its amplitude magnified with a preamplifier (122 A, Physical Acoustic Co.), and the data analyzed with an acoustic emission analyzer (LOCAN Jr, Physical Acoustic Co.).
The initial fracture site was ascertained from the lag in acoustic emission arrival time, frequency of acoustic emission, maximum amplitude of acoustic emission, and distribution of maximum amplitude. The amount and ratio of energy release were also calculated.
The following conclusions were drawn from this study:
1. It is possible to determine the initial fracture point and to follow the exact phases of the fracture process.
2. Prediction of the fracture time based on increased frequency of acoustic emission seemed difficult because the total frequency of acoustic emission varied structurally with a load-strain increase.
3. By calculating the ratio of energy release it seemed possible to predict the extent of bone fracture under d given load.

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The purpose of this study was to define the vascular pattern of the forehead flap and examine its possible future uses.
Materials and Methods:
Angiography: I used 10 cadavers (3 males, 7 females) which had been injected with contrast medium, and took the materials from these cadavers by resection at the pericranial superficial layer. After X-ray photographs and angiograms, I examined the vascular pattern. Then I split the material into the fascial layer and the cutaneous layer and examined the vascular pattern of each layer by the same method. I also examined the pattern of forehead flaps experimentally raised on the cadavers.
Dye injection: I carried out this method on 18 sides of 16 patients during arterial catheterization for chemotherapy. The catheter was selectively inserted into the frontal branch of the superficial temporal artery and indigocalminum solution was injected as dye. After injecting 10ml of dye at a speed of 1ml/sec, the dyed area was recorded. Then another 10 ml was injected interrupting the adjacent arteries with digital pressure, and the dynamic change of the dyed areas was observed. The same method was carried out on a fresh cadaver and results were compared.
Cadaver dissection: I studied anatomically the tissues related to the forehead flap.
The results were as follows.
1. The vascular pattern of each layer was characteristic.
2. The vascular pattern of the superficial temporal artery was not a direct cutaneous artery, but was fasciocutaneous artery, and consequently forehead flap preserving the frontal muscle should be called a fasciocutaneous flap.
3. I showed the anatomical territory of each artery by dye injection and this dynamically changed when the adjacent arteries were interrupted. This change clearly demonstrated the dynamic territory. The largest dynamic territory of the frontal branch included 6 anatomical areas.
4. I examined the course of the superficial temporal artery and the temporal branch of the facial nerve within the temporoparietal fascia, and demonstrated the differences in its course between the layers.
5. I investigated the distribution of the facial nerve and the superficial temporal artery. As a result of this study, I could demonstrate the landmarks for raising flaps without facial nerve injury.
6. By preserving the frontal muscle and the frontal branch of the facial nerve, past cosmetic and functional disadvantages could be improved.

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1. Physiological responses during tooth extraction, including plethysmogram, GSR, heart rate, blood pressure and RPP, were measured, and the obtained data were recorded and analyzed by computer. As the subjects, 127 healthy adults, 67 patients with hypertension and 41 patients with heart disease were used.
2. When the amounts of stress were compared according to the treatments used, plethysmogram and GSR were found to be larger at the time of anesthesia and tooth extraction and during a preoperative period; heart rates increased after anesthesia; changes in blood pressure were larger at the time of anesthesia and tooth extraction.
3. When the amounts of stress were compared according to the subjects' ages, responses with plethysmograph were large in the age group of 39 years or below, but were small in the age group of 60 years or above. Similar results were seen with GSR. Heart rates were fewer in aged patients than in younger patients, and the aged patients also showed smaller heart rate changes. Blood pressure was the highest and showed the greatest changes in the age group of 40-50 years.
4. In comparison of the diseased group with the healthy group, plethysmograms had larger waves in the diseased group, and this group showed poor responses. Changes in heart rates were larger in the diseased group at the time of tooth extraction. The diseased group showed greater changes in blood pressure during a preoperative period and at the time of anesthesia and tooth extraction than did the healthy group. RPP was larger in the deseased group than in the healthy group, and changes in RPP were higher at the time of anesthesia and tooth extraction.
5. Plethysmogram and GSR well reflected mental responses, while the other parameters well reflected cardiovascular dynamics.

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This study was carried out to evaluate articulatory movement of patients with mandibular prognathism. The subjects in this study consisted of twenty-six cases of mandibular prognathism (9 males and 17 females). Subjects were divided into three groups according to the magnitude of overjet; slight overjet less than -4 mm, moderate overjet between -4 mm and -7 mm and sever overjet exceeding -7 mm. In these subjects speech intelligibility and distorted sounds were evaluated and compared to five healthy persons. In addition, the findings of dynamic palatograms of the subjects during the phonation of /ara/, /asa/and /ata/were studied. The following articulatory characteristics were observed.
1. In speech intelligibility testing, the mandibular prognathism patients proved to have slight articulatory disorders. These disorders were most apparent in the group with severe overjet. There were significant differences in some sounds between this group and healthy persons.
2. The patterns of the dynamic palatograms of mandibular prognathism patients showed anterior displacement and a small area of palatolingual contact in comparison with those of healthy persons. This finding suggested the cause of the articulatory disorders to be foward positioning of the tongue.
3. The patients' distorted sounds were frequently recognized in lingodental and alveolar sounds. The patterns of the dynamic palatograms of distorted sounds /s/and /t/showed anterior and narrow palatolingual contacts or asymmetric contact.
4. These results suggest that the articulatory disorders of these mandibular prognathism patients were due to anterior displacement of the tongue or habitual asymmetric tongue movement.

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In this report, we described the details of a lung metastasis of adenoid cystic carcinoma arising in the sublingual gland.
A 49-year old male had the chief complaint of swelling at the left submandibular region, a malignant tumor was suspected by clinical diagnosis using CT scan, echography, and RI imaging scan. This showed an irregular centric solid mass in submandibular region. Breast X-ray also gave a suspicion of lung metastasis lesion by a phantom breast X-ray of posterioranterior finding, fuji computed tomography and CT scan. The patient has undergone resection of the primary tumor and middle lobe of the right lung. Irradiation of 50 Gy for the submandibular region and immunochemotherapy were followed postoperatively. Patient is alive and tumor free for 2 years 7 months. Histological examinations of both submandibular and lung lesions revealed adenoid cystic carcinoma (grade I, T_2aN₀M₁, stage IV).

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In 60 patients of unilateral painful temporomandibular joint dysfunction (TM JD) consisting of 20 each of myogenic, arthrogenic and mixed (myo-arthrogenic) type subjects, skin temperature was measured at before and after treatments on the bilateral masseter muscle insertion regions with using a thermography apparatus (Thermotracer 6 T 66, Nihon Saneidenki).
The diseased side skin temperature (TD) was standardized by the healthy side skin temperature (TH), i.e., by calculating the difference by the following formula: TD-TH. The results obtained were as follows.
1. In myogenic type, averaged comparative difference (TD-TH) was calculated as-0.25±0.26°C. Out of 20 cases, eleven subjects showed clearly lower TD. TD of 8 subjects was not significantly different from TH, and only one case exhibited higher TD.
2. In mixed type, the affected side skin was 0.31±0.28° colder than the normal side. TD was clearly lower in 13 cases, not significantly different from TH in 6 cases, and elevated in only one case.
3. In arthrogenic type, no difference between TD and TH could be observed in general, and most subject TD was within the range of TH division.
4. The skin temperature was correlated with therapeutic effects. Lowered TD elevated remarkably and reached to about TH with disappearing of the symptoms, and the difference in both sides (TD-TH) was just only -0.08±0.24°, -0.01±0.18° in myogenic and mixed type, respectively.
From the results, it was thought that musclar tissue associated with TMJD becomes ischemic and affects the overlying skin temperature. It was also suggested that skin temperature estimation is useful for identification of musclar involvement and also for evaluation of the therapeutic effects.

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Head and neck squamous cell carcinoma mainly tends to occur in people aged between 50 and 70. However, the incidence of head and neck cancer among aged and young patients has increased in recent years. In this report, we compared the clinical findings and therapeutic courses between both groups.
The incidence of patients with tongue cancer was mostly in the young group occupying 48.2%, while gingival cancer of lower jaw was mostly in the aged group.
With regard to the advanced cancer cases, aged patients outnumbered young patients. We treated all young patients by radical method, while we have chose palliative therapy for 30.8% of the aged patients by reason of their systemic complications or advanced tumors.
Systemic complication patients occupied 69.2% in the aged group, which was three times higher than that of the young group (22.2%).
The three-year survival rate was 84.0% in the young patients and 51.3% in the aged patients.
The young patients below 39 years old showed higher distant metastases rates after primary therapy. It may be important to know physical features and the nature of tumors in young and aged patients to improve prognosis.
We planned radical therapy for the aged patients as far as systemic conditions permitted.

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A case of capillary hemangioma of the tongue increased in size during pregnancy is reported in this paper.
When a 20-year-old female patient was 8 months pregnant, she noticed a small painless tumor at the apex of the tongue. The tumor rapidly grew during 9 to 10 months of pregnancy. But after delivery, the tumor did not show increased size. Intraoral examination revealed at the time of visit to our hospital, a pedunculated tumor mass of the tongue with a lobulated surface. Surgical extirpation was performed under local anesthesia 2 months after delivery. Histologically the tumor was composed of multinodular masses consisting of many small capillaries lined by single layer of endothelial cells. Ulcerations of covering epithelium with mono-nuclear cell infiltration were seen.
By above-mentioned clinical and histological findings, it was suggested that the behavior of the present tumor had some relationships to pregnancy hormonal unbalance.

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Fifty-three closed lock cases of internal derangement of the temporomandibular joint (TMJ) were studied on the correlation between clinical status and duration of closed locking.
The anterior disk displacement was diagnostically verified by MRI. Clinical symptons and status were obtained through both physical examination and questionnaire. The questionnaire consisted of visual analogue scale of pain, pain score, jaw dysfunction score and life activity limited score, and they were quantitatively evaluated.
The age and locking duration averages in 53 patients were 29.5 years old and 8.3 weeks, respectively. Clinical subjective symptons such as pain and jaw dysfunction were little related with closed lock duration. Only the interincisal opening distance was correlated with locking duration, especially strongly in positive in the younger group below 20 years of age. On the other hand there was not any statistically significant relationship between the interincisal opening distance and clinical symptons.
These results indicated two independent therapeutic goals; relief from pain and increasing of ROM (range of motion) of the mandible should be sought by means of non-surgical and/or surgical treatments for closed lock TMJ patients.

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Twenty cases (4.3%) of multiple primary malignant tumors, including 3 cases of oral multicentric carcinoma, were found among 463 patients with malignant tumor of head and neck region at the our department, from September, 1978 through August, 1989. Ten were male and ten were female. Their mean age was 67.7±11.5 years with a range 34 to 82 years. Synchronous (within 1 year) tumor were 8 cases and metachronous were 12. The average interval between the first and second tumors was 4.0 years with a range of from 6 months to 14 years.
There was a wide variety of other tumors distributed as follows: pharynx (3), bladder (2), and parotid region, thyroid, bronchus, breast, esophagus, stomach, uterine cervix, and skin, each. One of this group, forty percent (8/20 cases, including oral multicentric carcinoma) were combined cancers of digestive system.
Three cases of radiation induced cancer were found.

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A blue nevus in the oral mucosa is an uncommon pigmented lesion originating from melanocyte, and a case of a blue nevus arising in the buccal gingiva of the canine area of the right mandible of a 10-year-old male is reported.
The slightly elevated lesion was a brownish black mass, measuring 10 mm in diameter, that was excised completely under local anesthesia.
Histologically, the pigmented mass consisted of spindle-shaped melanin-producing cells located in the deeper portion of the connective tissue. Ultrastructurally the cells revealed numerous melanomes in varying stages of development in the cytoplasm and basal lamina occasionally in their outer surfaces.
The postoperative course was favorable and there has been no recurrence.

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It is known that alcohol consumption is an important cause of oral cavity cancer. We encountered two cases of alcoholism oral cancer. Case 1 was a 51 year old man with carcinoma of the tongue (T2N0M0) Case 2 was a 47 year old man with carcinoma of the oral floor (T1N1M0). Since both cases had the habit of smoking, it was suggested that heavy drinking and smoking synergistically influenced the development of their oral cancers. These cases were diagnosed early, thereby could be treated by radical operation with chemotherapy.
Since almost all Japanese alcoholics have the habit of smoking, they are regarded as a high-risk group for oral cancer. So it is suggested that a mass screening of alcoholics is necessary for early detection of oral cancer.

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We studied about 4 cases of unoperated cleft palate patients up to grow-up; 3 cases of cleft lip and palate received lip operation in infancy and 1 case of cleft palate alone.
Their maxillofacial patterns, dental arches and occlusal conditions were analyzed by means of lateral roentogenographic cephalogram and measurement of dental cast, and we observed differences compared with normal adults.
The results may be summarized as follows:
1. The maxilla growth in all patients was distributed in normal range.
2. Three patients with cleft lip showed slight inhibition of the outward growth of maxilla, consequently a little constriction was observed in their dental arch, whereas the case of cleft palate alone was nearly normal adult.
3. The dentition of front and molar part teeth showed a state of normal occlusion and the maxillo-mandibular were mainteined in good condition.
Our results suggested that the maxillar growth capacity in cleft palate patients was similar to that of normal adults.

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Lingual osseous choristoma is a rare lesion. We describe a case of lingual osseous choristoma in a 23 year old female. The lesion appeared as a pedunculated mass measuring about 4×4×8 mm, near the foramen caecum of the tongue. The mass was excised under general anesthesia. Histologically this lesion consisted of a well circumscribed mass of dense lamellar bone with Haversian canals. The bony nodule was bordered by a narrow band of dense fibrous tissue, and covered with squarnous mucosa. The excised area of the tongue was healed and free of recurrence one year later.

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This is a case report of oro-facial-digital syndrome type I. The patient was a female infant with brittle hair, millet grain papulla and micrognathia. Oral examination revealed that she had cleft tongue, tongue tumors, severe short tongue tie and thick frenula extending from the buccal to the gingival mucosa. She had no limbs anomalies. Chromosomal a analysis revealed a normal number and conguration of chromosomes. The oral anomalies were treated surgically when she was one year and nine months old.
Oro-facial-digital syndome type I is a rare hereditary disease characterized by oral anomalies, peculiar face and anomalies of the hands. It is believed that the inheritance appears to be X-linked dominant with lethality in males. The majority of patients studied have had normal karyotypes.

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Recently we experienced two patients diagnosed chronic sclerosing submandibular sialadenitis. They are males 73 and 47 years of age, each with the chief complaint of swelling of the right submandibular region, and the major symptom of tenacious tumoral changes of the submandibular salivary gland.
On ultrasonic examination, an image of the solid lesion with a relatively clear outline was obtained in each case. In particular, the internal echography resulted in heterogenous low echo.
Sialogram disclosed irregular dilatation of the major and the peripheral ducts, as well as leakage of contrast medium into the grandular parenchyma. Especially in Case No.2, the contrast agent filling the duct was of a lower density, suggesting possible foreign matter presence.
Sialoadenectomy was performed in these cases, and chronic sclerosing submandibular sialoadenitis was diagnosed by histopathology. In case No.2, a foreign matter of phytoid fibers was found in the main duct of the submandibular gland.

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The concept of odontogenic keratocyst was introduced by Philipsen in 1956 and described some of its clinical, radiological and microscopic features. This cyst has a thin wall characterized by keratinizing epithelium.
A rare case of odontogenic keratocyst which extended into the contralateral site of maxilla is reported.
A 25 year old woman who complained of right cheek swelling for approximately 10 years, was referred to our hospital September, 1984. Radiological examination revealed a large unilocular radiolucent area in the right maxilla. CT scan revealed a soft mass from the left incisor area to the right molar area suggesting ameloblastoma formation. On the ninth of October, 1984, the lesion was totally enucleated. There was no relationship to any tooth. Histological findings show that the lining epithelium of cyst wall is stratified squamous with parakeratosis and the connective tissue contains islands of epithelium and separated small cysts.
A diagnosis of odontogenic keratocyst was made.
The patient showed no evidence of recurrence of the cyst for 55 months postoperatively.

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Magnetic Resonance (MR) Imaging with surface coils is a proved method for assessment of internal derangements of the ternporomandibular joint and is rapidly surpassing arthrography and CT as the imaging method of choice.
The major advantages of MR imaging in comparison with arthrography and CT are; 1. it is noninvasive, 2. it requires no ionizing radiation for image acquisition, 3. it permits direct visualization of the disk and joint structures.
Examinations of the TMJ were performed on a 1.5 tesla imaging system (Magnetom, Simens Co.) using a Modulated Helmholtz type coil. 17 cm in diameter developed in Kameda General Hospital in order to increase signal to noise ratio in the area of bilateral TM.Js. The repetition time (TR) was 120 msec, the echo time (TE) was 15 msec, and field of view was 17 cm. The data matrix was 256×256. The following results were obtained:(Note: colon should be used)
1. Sagital MRI of normal TMJ in the closed position: The image showed the normal biconcave lens-like configuration disk, with the posterior band in the superior position.
2. Sagital MRI of normal TMJ in the open position: The disk was interposed between the condyle and tubercle.
3. Disk displacement with reduction: The image showed anterior displacement of disk, with the jaw open the disk had normal relationship to the condylar head inferiorly and the tubercle superiorly.
4. Disk displacement without reduction: The image showed the disk remains displaced anterior to the condylar head at all jaw positions.

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A typical case of klippel-Feil syndrome with submucous cleft palate of one year six months old boy was presented and its speech disorders were discussed.
1. In speech findings, hyper nasality, articulation disorders and speech retardation as low as physical development were observed.
2. In oral findings, midline posterior bony palate notching defect, midline soft palate muscle separation with an intact mucosal surface and morphic abnormity of uvula for submucous cleft palate were observed.
3. It was though that his speech disorders were caused by incomplete of nasopharyngeal closure.
4. In treatment involved 1) instructing his mother, 2) food chewing, 3) dental treatment, 4) wearning speech aid, and 5) articulatory therapy. But, his reactive behavior was such that wearing speech aid as in No.4 above of the treatments could not be used, so we performed palatoplasty on him at four years three months. After this, we will perform speech control and follow up a long range plan with various related departments.

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Hepatocellular carcinoma (HCC) rarely metastasizes to the oral and maxillofacial regions. To our knowledge, only 24 cases have been reported. Two additional cases of metastatic HCC in the oral and maxillofacial regions are reported and related cases reported in the literature are reviewed. A 47-year-old man complaining of swelling of the right TMJ and a 63-year-old man complaining of buccal swelling, in both cases, the primary lesion was diagnosed only after diagnosis of the oral and maxillofacial lesion.

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Ameloblastoma of the maxilla is rare, even rarer is the malignant variety of the tumor.
The World Health Organization defines a malignant ameloblastoma as “A neoplasm in which the features of an ameloblastoma are shown by the primary growth in the jaws and by any metastatic growth.” By thus taking metastasis as the principle criteria for diagnosis, this definition excludes such histological considerations as the presence of less-differentiated areas within the tumor.
We experienced the case of malignant ameloblastoma in the maxilla of a 68-year-old man. On clinical examination, metastasis was suspected, but could not be established conclusively. A biopsy showed, however, the features of an ameloblastoma having some lessdifferentiated areas. On this basis, we diagnosed the tumor as malignant ameloblastoma, despite the WHO definition.
This report describes the clinical course of the case, reviews the Japanese literature concerning this type of tumor, and discusses possible new diagnostic criteria.

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In the field of oral and maxillofacial surgery, since symptoms appear in and around the oral cavity, we have used tube feeding for post operative nutritional management.
Many kinds of enteral nutrients have been developed and put on the market, but had some weak points.
In this study, comparison was made between Besvion^®and conventional liquid diet with respect to the nutritional state and side effects. It was concluded that Besvion^®was a superior product and appropriate as enteral nutrient in oral and maxillofacial surgery.

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