The angioarchitecture of 9, 10-dimethyl-1, 2-benzanthracene (DNIBA)-induced carcinoma of the tongue in hamster was examined mainly by resin cast method using specimens at 5 stages (initial, diffuse growth, minute granu.liform elevation/small buldging, papilloma and cancer stages) with special reference to angiogenesis. Innervation of the vessels was also examined by catecholamine (CA) fluorescence, acetylcholine esterase (AChE), and horseradish peroxidase (HRP) histochemical methods. The results obtained were as follows:
1. From the initial to the diffuse growth stage, elongation and enlargement of capillary loops in the tunica propria mucosa became visible.
2. After the minute granuliform elevation/small buldging stage, characteristic capillary loops were often observed in the resin cast preparations suggesting a possible participation of budding and fusion in the angiogenesis.
3. At the papilloma stage, the resin cast of the vasculature revealed a characteristic tree-like constitution having extremely swollen tips. Cross sections of the vessels also revealed their unique wall structures, as swollen and thin as sinusoidal vessels.
4. At the carcinoma stage, extremely flattened or shrunken vessels were predominant, however some buddings were also found suggesting a continuous involvement of angiogenesis.
5. At the external growth part from the initial to the papilloma stage, the tunica propria mucosa frequently exhibited an apparent increase in thickness. Both the HRP and the CA positive nerves were observed in the thickened mucosa. These nerves, however, were not seen at the cancer stage.
6. In the musculature infiltrated by cancer cells, both the CA and the AChE positive nerves innervating the blood vessels tended to degenerate and disappear. The HRP positive nerves also showed a degeneration due to cancer infiltration, although it remained unclear whether they were related to the vessels or not.
7. The budding, elongation, enlargement, and fusion of capillary loops in the tunica mucosa may play a role in the rapid formation of the characteristic vascular architecture of DMBA-induced carcinoma of the tongue.
8. The tumor blood vessels, whose walls were very thin and were mainly composed of endothelial cells, may be suitable for the rapid increase in the vessel volume. Because of such characteristic features, the tumor blood vessels may easily flatten, close their lumens, and regress under high tissue pressure at the cancer stage. These structural alterations in blood vessels may finally result in degeneration of the tumor.
9. The paucity of musculature and innervation in the tumor blood vessels suggests that the vessels serve the tumor as the exchange vessels rather than the distributing vessels. The tumor blood circulation, therefore, seems to depend on the control mechanism of the external vessels of the tumor.

抄録全体を表示

Forty one dentoalveolar abscesses of endodontic origin were examined bacteriologically. Pus was aspirated, immediately inserted into RTF under a stream of anaerobic gas, sealed tightly with a butyl gum stopper and transferred to the laboratory. The sample was serially diluted and smeared on blood agar plates in duplicate. One plate was incubated anaerobically for 7 days and the other aerobically for 4-7 days. Bacteria were isolated in 32 of 41 cases and the standard number of isolates was 3.3×10⁷CFU/ml. Anaerobic bacteria predominated in 30 of the 32cases yielding positive culture. In anaerobic bacteria, gram negative rods were predominant, especially species of Bacteroides were isolated from 30cases, followed by species of Peptostreptococcus (65.6%) and Eubacterium (40.6%). Ps. micros (17 cases), B. intermedius (16cases), B. ruminicola (13 cases), B. bivius (13cases), E. lentum (11 cases), Ps. anaerobius (11cases) and Ps. productus (10cases) were identified as major constituents. These genera and species are similar to those found in a symptomatic periapical pathosis. However, in this experiment, proportional distribution of B. intermedius is quite different from previous data of symptomatic periapical pathosis. B. intermedius was most prevalent and occupied more than 40% of the isolates from 9 cases in this experiment. These results indicate that B. intermedius may exert an important influence on exacerbation of periapical pathosis.
In API ZYNI system, enzymatic activity patterns of B. intermedius and F. nucleatum were the same as those from symptomatic periapical pathosis. In this experiment, however, many isolates produced additional activities. Furthermore, MIC value of various antibiotics against major constituents were higher than those of isolates from periapical pathosis or oral microbial flora. These results suggest that the derivation of bacteria in these cases might be due to persistence of bacteria, but not due to anachoresis.

抄録全体を表示

Following an experimental implantation of a hydroxyapatite block, we implanted a hydroxyapatite block on one side and an iliac crest on the other side of the lower jaw bone of an adult dog to study a bone remodelling process that occurs in the implantation bed, the surrounding alveolar bone and a distant part of the mandible.
In this experiment, two types of hard tissue labelling agents were used for time tracing examination. The large ground sections of these grafts were also studied by means of microradiography.
1. In the case of iliac bone transplantation, bone resorption was observed in a wide area of the alveolar bone before new bone formation occurred actively. The bone formation gradually decreased in velocity and around the 60th day after surgery, it was observed within limited areas such as in the transplantation bed, the surrounding alveolar bone, and a compact bone in the lower margin of the jaw bone.
2. Up to about the 8th day, bone formation started in the alveolar bone around the transplantation bed. Around the 60th day, remodelling took place in the newly formed bone and the surrounding alveolar bone, and then porosity was produced in the trabeculae. Forty days after surgery, the implanted iliac bone was resorbed and then disappeard completely.
3. There were two ways in which the resorption of the transplanted bone and the formation of the new bone took place. In one way, the resorption of the transplanted bone was followed by the proliferation of the new bone from the base to the top of the transplantation bed.
In the other way, resorption and new bone addition progressed alternately until the transplants were replaced by newly formed bones completely.
4. Around the 180th day, the trabeculae near the top of the transplantation bed became stratified and dense, while that in the base area became polyporous.
5. Up to about the 60th day, bone addition continued on the surface of the compact bone in the mandibular canal below the transplanted bone, but afterwards the bone addition became stagnant.
6. In the area adjacent to the implanted hydroxyapatite, new bone formation and internal remodelling occurred basically in the same way as in the case of the iliac bone transplantation, but most hydroxyapatite ceramics were not replaced by newly formed bones.
7. Bone proliferation was not observed in the hydroxyapatite pores before the 30th day and no trabecula was formed until the 90th day.

抄録全体を表示

A clinico-statistical and follow-up study was made in 100 cases of mandibular condylar fracture in the First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokyo Medical and Dental University. The following results were obtained;
1. There were 62 males and 38 females. The ages of the patients at the time of injury ranged from 0 to 80, and the average was 29. 5 years old.
2. Eighty-five cases were treated within 2 weeks after injury.
3. Of all cases, 85 cases were unilateral fracture, and 15 were bilateral fracture. Direct fracture of the condyle was observed only in 5 cases.
4. Fracture position and form were determined according to the classification described by Kubo. Mandibular cervical dislocation was most frequently observed.
5. All cases were treated with a conservative therapy; intermaxillary fixation, chin cap, mouth opening training, etc.
6. In the results of follow-up examination by mail, 18.5% of all patient had a restriction of the mouth opening, 40.7% had a pain, and 64.8% had a joint sound. In unilateral fractures, 39.1% of the non-fractured joint had a joint sound.
7. The analytical results on the fracture type and present symptoms revealed that the patients with no displacement fracture had little dysfunction. On the contrary, those who had a displacement fracture had more problems. In conclusion, a preserved anatomical structure of TMJ proved to be the most important factor to heal mandibular condylar fracture.

抄録全体を表示

A case of exostosis at the inferior border of the mandible was reported. The patient was a 66-year-old woman who complained chiefly of painless swelling at the inferior border of the left mandible. Physical examination disclosed a firm and hard mass, adhering to the inferior surface of the mandible. Roentogenograms of the mandible disclosed a cylindric, radiopaque appearance, which extended outward beyond the normal inferior border of the left mandible. The clinical diagnosis was exostosis. Surgical removal of the bony mass was done under local anestl-esia. The bony mass was about 6 mm in diameter and 12 mm in length. Its histopathological diagnosis was also exostosis. Generally, exostosis is not a rare disease, but such cylinder shaped exostosis occurring at the inferior border of the mandible as seen in this case was extremely rare. And we could not find out the cause of the lesion in this case.
The patient was last seen about two years after the operation and no evidence of further trouble was found clinically and roentogenologically at that time.

抄録全体を表示

Basal cell nevus syndrome is primarily considered to be an autosomal dominant hereditary disease frequently accompanying basal cell epitheliomas, multiple jaw cysts, anomalies of the rib, palmar and plantar pits, calcification of the cerebro-falx, and various skin and skeletal anomalies.
We recently experienced 6 cases of this syndrome. Among them, there were 2 cases of family involvement, a case of a father and his daugther and a case of a mother and her son. In one case, ulcerous nevie was observed in the arm, which was revealed to be a basal cell epithelioma histopathologically after removal of the ulcer. All cases had multiple jaw cysts and they were all of odontogenic keratocysts pathologically. In two cases the jaw cyst recurred.
In those patients with basal cell epithelioma and multiple jaw cysts, it se ms necessary to observe for a long follow-up period.

抄録全体を表示

Few studies have been reported on a long-term prognosis and the jaw functions after surgical treatment for temporomandibular joint disease. In this study, we examined the jaw function of the patients by mail questionnaire who had their mandibular head (s) removed on account of condylar process fracture. In addition, a few analytical results on the jaw movements using MKG are also presented in this article.
During the period from 1983 to 1988, seven patients (four males and three females; ages from 12 to 65 years; mean age 38.6 years) were evaluated, and six of them had unilateral fracture of condylar process and one bilateral. All patier ts complained of slight difficulties in the jaw movements and pain, though they reported to be satisfied with the result of the treatments.

抄録全体を表示

Peripheral ameloblastoma which histopathologically resembles a typical intraosseous ameloblastoma occurs in the soft tissue outside the alveolar bone. We describe a case of peripheral ameloblastoma arising in the gingiva of the premolar region in the left mandible of a 36-year-old man. A brief review of the literatures reported so far in Japan on this lesion and its differential diagnosis in relation to basal cell carcinoma are discussed.

抄録全体を表示

The purpose of this study is to evaluate the usefulness of operative arthroscopy using on electric cautery and shaver system and Yag-LASER performed in 23 cases (25 joints) of internal derangement with closed lock of the temporomandibular joint (TMJ).
The patients consisted of 2 males and 23 females, with an average age of 35.3 years (15-62), and had a locking duration of 6.6 months (0.1-36) on average. Preoperatively, the average interincisal opening distance was 28.9mm (22-36), with moderate to severe arthralgia in 23 joints. Using a triangulation technique via a second puncture, diagnostic arthroscopy was performed, followed by abrasion of the intra-capsular fibrous adhesion by monopalar or LASER and extirpation of fibrous tissue by electric shaver. As a result, the postoperative interincisal opening distance averaged 40.3mm and the average improved distance of 11mm was obtained. The arthralgia recovered to painless in 12 joints, slight in 10 joints and moderate in 3 joints. According to our criteria, the surgical success rate was 92%, being exellent in 16 joints, good in 7 joints, and failure in 2 joints. In conclusion, an operative arthroscopy using these surgical instruments was thought to be extremely useful in treating an internal derangement of the TMJ.

抄録全体を表示

In recent years various artificial skins and wound dressing materials have been used in plastic surgery and dermatology for burn skin, donor site, graft site, peel-off/wear away site, and traumatized, worn away skin.
Among these artificial dressing materials, a “chitin” wound dressing extracted from red “zuwai” crab (Beschitin-W^®, Unichika-Roussel Medica Co.) is made by a fibrous version of its main component, N-acetyl glucosamine. This dressing has numerous advantages over similarly-developed freeze-dried dura, pigskin, or collagen membrane. The well-known properties include its high biocompatibility, accelerated granulation and epidermis formation, high-grade efficacy, no or extremly mild side effects, virtual absence of antigenicity and minimized risk of breakdown.
We have used this dressing for treating oral mucous defects with success; herein is a summary of such treatment. In this study, we used Beschin-W^® in some of our patients with oral mucosal problems including gingiva and tongue developed during surgery.
Good clinical courses observed in these patients are reported in this article.

抄録全体を表示

A case of maxillary antrolith caused by fungus ball in a 73-year-old male is presented. Computed tomography showed a calcified mass in the right maxillary sinus. A caseous substance found with fiberscope in the orifice of the right maxillary sinus was examined histopathologically and revealed to be fungus ball. Under the clinical diagnosis of fungal infection of the right maxillary sinus, he was treated surgically. The Fungal culture on Sabouraud agar media was negative. Irrigation of the right maxillary sinus was perlbrmed with PVP-I for three months after the operation. The prognosis was excellent. The calculi were postoperatively examined by PAS-staining, FIE-staining, SEM, TEM and energy-dispersive X-ray analysis (EDX).
The marginal region of the calculi was PAS-positive and other regions were PAS-negative. A number of fungal hyphae of 2.5 to 5μm in diameter with dichotomous branching were observed in the marginal region. SEM findings showed a rock-like surface with many small holes. TEM findings showed some cell wall-like structures similar to fungi. Calcium (20.85%), phosphorus (11.84%) and magnesium (1.38%) were detected by EDX.

抄録全体を表示

A clinico-statistical observation was performed on in-patients so far admitted to the department of dentistry and oral surgery of Kinan General Hospital during the past 6 years.
1. The total number of patients was 447, of which 297 were male and 150 were female (1.98: 1).
2. Among various age groups the sixties accounted for 19.0%(85 cases), then the forties for 16.3%(73 cases).
3. The incidence of diseases was as follows: trauma 103 (23.0%), malignant tumors 97 (21.7%), inflammatory diseases 90 (20.1%), cysts 77 (17.2%), postoperative state of facial bone fracture 42 (9.4%), benign tumors 12 (2.7%), multiple caries 11 (2.5%), malformations or deformities 9 (2.0%).
4. From the regional point of view, 190 patients (42.5%) were referred from Tanabe coy, the seat of our hospital.
5. The average day or hospitalization was 22.9 days.

抄録全体を表示

Primary parotid squamous cell carcinoma is a comparatively rare tumor. A surgical procedure is usually a treatment of first choice for this type of tumor. Although radiation therapy has been applied to this tumor postoperatively, it has never been its main therapy. The prognosis of this tumor has been poor in general.
This paper reports a successful case of parotid squamous cell carcinoma by means of external and interstitial radiation therapy. A 55-year-old man complained of the right buccal swelling with fluctuation and mobilities of the first and the second molar of the mandible. In spite of abscess incision, antibiotic administration and teeth extraction, no improvement was observed. Biopsy was then carried out and the histopathologic finding revelaed a squamous cell carcinoma.
After 41.4 Cy of external ⁶⁰Co radiation and 85 mg of pepreomycin injection, 8 and 5 needles of 1 mg and 2 mg radium respectively were inserted into a single plane and delivered 70 Gy for 7 days.
After 70 months the primary region was completely controlled with no evidence of metastasis and side effect.

抄録全体を表示

Eosinophilic granuloma of soft tissue mainly appeares as a tumor-like nodule in the subcutanous head and neck region. Histopathologically, it is characterized oy the presence of lymphoid follicles, and marked infiltration of eosinophils, as well as fibrosis and vascular proliferation.
We reported 4 cases of cosinophilic granuloma of soft tissue in the parotid-massetcr region, inferior surface of the tongue and buccal region. We obtained successful results by surgical procedures and/or radio therapy.

抄録全体を表示

Pemphigus vulgaris is a chronic erosive and bullous disease of skin and mucous membranes histologically characterized by acantholysis and degeneration of epithelial cells.
The authors report a 44-year-old female of pemphigus vulgaris who showed erosion of 2-5 buccal and lingual gingiva as a single lesion. The diagnosis of pemphigus vulgaris in this case was made by clinical evidence of Nikolsky's sign, immunological evidence of positive vulgaris antibody, and laistopathological findings including Tzanck test results. This case had no recurrence for the past 4 years after local injection of steroid hormone and gold therapy.
The authors discussed the treatment of pemphigus vulgaris of buccal and lingual gingiva and emphasized the effect of locally injected steroid hormones.

抄録全体を表示

For the past 5 years, free buccal mucosal grafts have been used for reconstruction of defects following surgery of a small superficial tumor or post-traumatic scar in 11 patients.
Clinical and/or histopathological diagnosis of the 11 patients were 5 cases of squareous cell carcinoma of the tongue, an 1 case each of leukoplakia of the tongue, erythroplakia of the tongue, lymphangioma of the retromolar region, denture fibroma of the oral floor, neurofibromatosis of the alveolar ridge of the mandible and post-traumatic scar.
Results were satisfactory and free buccal mucosal grafts were very useful for reconstruction of a small superficial defect in the oral mucosa.

抄録全体を表示

Verrucous carcinoma, a variant of squamous cell carcinoma, was first described as a distinct clinical and histopathological entity by Ackerman in 1948. In this paper, two cases of verrucous carcinoma of the oral cavity are reported. One case was treated by surgical excision, but the other rejected the treatment. The first case is free from recurrence as of today, 4 years and 4 months after surgery.
Ultrastructural observations demonstrated that gap junctions and desmosomes were numerously found in the verrucous carcinoma.
A well preserved intercellular junction might be rclatcd to a better prognosis of this lesion in comparison with invasive carcinomas.

抄録全体を表示

Clinico-statistical observations on 104 cases of bilateral TMJ disorders are presented. The proportion of bilateral TMJ disorders (BTMJD) to the total patients of TMJ disorders was 23.1 percent. BTMJD occurred most frequently in the twenties and was predominant among female patients. The most common chief complaint was TMJ pain or TMJ sound. There were no significant differences in the age and sex distribution and the chief compaint between BTMJD and unilateral TMJ disorders. Among the initial symptoms of BTMJD, muscle symptoms mostly occurred bilaterally, but TMJ pains occurred unilaterally. TMJ sounds occurred equally in the bilateral and unilateral groups. The period from the onset of BTMJD symptoms to the initial visit to a clinic was longer than that for unilateral TMJ disorders. As for the present condition, most patients of BTMJD had several composit symptoms, TMJ pains+TMJ sounds or TMJ pains muscle symptoms. They rarely presented a similar symptom on both sides. Bilateral TMJ pains and bilateral TMJ sounds were concurrently recognized only in 11 cases. Bilateral TMJ pains and bilateral muscle symptoms were simultaneously recognized only in 11 cases as well. Most of the unilateral TMJ pains were accompanied with TMJ sound on the other side, but many of unilateral TMJ pains were recognized on the same side as that showing unilateral muscle symptoms. Difficulty in opening the mouth wide (<39mm) in unilateral TMJ disorders was severer than in BTMJD.
From these analyses it is thought that BTMJD have bilateral derangement of the TMJ disc and condyle or tenderness of the masticatory musculature that were acquired under a persisted abnormal condition of the masticatory system. Furthermore, many of the symptoms of BTMJD are mild in general but BTMJD may be resistant against an ordinary treatment for TMJ disorders.

抄録全体を表示

Lung metastases were detected in 49 patients out of 382 with head and neck malignant tumors so for treated at the authors' clinic from 1971 to 1984. In 25 cases out of these, a locoregional lesion was controlled at the time when the lung metastasis was detected. The treatment and the prognosis of these 25 eases were reviewed.
1) The incidence of lung metastasis was 10.3% in patients with squamous cell carcinoma, 50.0% with adenoid cystic carcinoma, 18.2% with other adenogenetic carcinoma and 54.5% with sarcoma.
2) The 25 cases consisted of 17 patients with squamous cell carcinoma, 3 with adenoid cystic carcinoma, 3 with other adenogenetic carcinoma, and 2 with sarcoma.
3) Prognosis of the lung-metastasized squamous cell carcinoma was poor and 11 patients out of the 17 died within 1-year after the metastasis was confirmed.
4) Progression of the lung-metastasized adenoid cystic carcinoma was found to be gradual, and all the 3 patients with adenoid cystic carcinoma survived for more than 3 years.
5) A relatively longer survival period was noted in 3 patients out of 5 who had received a surgical resection of the pulmonary metastatic tumor.
6) There was no difference in the 3-year and the 5-year survival rate between the treated and the non-treated group.

抄録全体を表示