Sixty-six Wistar female rats, weighing about 300g, were employed in order to study the experimental healing process after microvenous anastomoses of the femoral veins, especially the recanalization phenomenon.
1. Throughout the experimental periods, venous anastomoses obstruction rates were 27.3%(18/66); that is, 2nd day, 33.3%(6/18), 4th day, 25.0%(5/25) and 7th day, 25.5%(7/28) respectively.
2. Having checked 2nd day, 4th day and 7th day postoperatively, all obstructed venous anastomoses reopened and flew again on 7th day after the first observation of the venous obstructions. Therefore, it is suggested that recanalization phenomenon can be confirmed experimentally after microvenous anastomosis.
3. Judging from histological and immunohistological findings, one of the causes of recanalization phenomenon is attributable to endothelial coverage of the anastomotic site, consequent desquamation and washout of the mural thrombus.

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We have generated a monoclonal antibody to the epidermal growth factor receptor, designated 12-93. This antibody reacted with non-carbohydrate moiety of EGF-receptor (EGF-r) and inhibits the binding of EGF to its receptor. Using 12-93 IgG, expression of EGF-r in normal oral mucosa, normal salivary gland and oral cancer tumor tissues were determined by immunohistological studies.
12-93 IgG staining appears largely restricted to basal cells on normal mucosa and ductal cells on normal salivary gland. On the other hand, cell membranes of all squamous cell carcinomas were uniformly stained but the intensity of staining was gradually decreased towards the center of cancer pearl.
In salivary gland tumors, tumor cells especially exhibiting ductal formation were weakly but definitively stained with 12-93 IgG. These results strongly suggest the possibility that the expression of EGF-r may be involved in the malignant transformation of cells in oral salivary gland as well as oral mucosa. Furthermore, this antibody may be useful to study the expression of EGF-r in oral tumors.

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Nineteen salivary gland tumors (16 pleomorphic adenomas, 1 undifferential carcinoma, 2 lymphadenoma) and 34 squamous cell carcinomas were assessed immunohistochemically using the polyclonal antibody against human c-erbB-2 gene product. The c-erbB-2 gene product-like immunoreactivity was detected in the cytoplasm of 9 cases pleomorphic adenomas (9/16; 56.3%), and no case of other salivary tumors and squamous cell carcinoma. There is a tendency that an expression of c-erbB-2 gene product-like immunoreactivity detected in ductal cells normal salivary glands, duct structure-like tumor cells, and scattered tumor cells.

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We investigated nuclear DNA contents of 21 oral leukoplakias by flow cytometry. Of the 21 leukoplakias, 6 cases (29%) were aneuploid. According to clinical examination, these leukoplakias were divided into a non-elevated type (10 cases), an elevated type (10 cases) and an elevated type with erosive lesion (1 case). One out of the 10 (10%) nonelevated cases, 4 out of the 10 (40%) elevated cases and 1 out of the 1 (100%) elevated case with erosive lesion were aneuploid. Histopathologicaly, marked epithelial dysplasia was noted in 3 cases and moderate dysplasia was observed in 10 cases. No obvious dysplasia was seen in the other 8 cases. Two out of the 3 (67%) cases with marked dysplasia, 2 out of the 10 (20%) with moderate dysplasia and 2 out of the 8 (25%) without obvious dysplasia were aneuploid.

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This experiment was intended to confirm the effect of the low power Nd-YAG laser in promoting the regeneration of peripheral nerves objectively. From immediately after sectioning and suturing the bilateral facial nerves in a rabbit, the dermal surface in the right experimental region was irradiated by the laser (power density: 713mW/cm², irradiation time: 30 min.) once daily and 5 times weekly up to the 4 th week.
The temperature of the dermal surface during the irradiation time was maintained at 40°C. A comparative experiment was made by irradiating infrared rays under the same conditions. No irradiation was made to the left side as control. Observation of the recovering course was made in the 4th, Sth, 8th, 10th and 12th weeks after the treatment. A comparative assessment was made both electrophysiologically and histologically, and the following results have been obtained.
1. Signs of recovery emerged earlier in the laser irradiaton group than the infrared irradiation group and control group electrophysioligically. The latency of action potential in the 8th week after the treatment was significantly short (p<0.05), and the threshold value in the strength-duration curve in the 6th, 8th and 10th weeks after the treatment was also significantly low (p<0.05).
2. In die histogram of the nerve fiber area, the peak value of the distribution was shown to be high in the laser irradiation group, compared with those in the infrared irradiation group and control group in the 6th and 8th weeks after the treatment.
From the above, it was clarified that the low power Nd-YAG laser promotes the regeneration of peripheral nerves, and it was considered that the thermal factor alone does not promote the regeneration.

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A case of calcifying epithelial odontogenic tumor (CEOT) with dentigerous cyst and unerupted tooth was presented.
Macroscopically, dentigerous cyst affeared to be divided into two areas by CEOT.
Histologically, the relation to reduced enamel epithelium, CEOT, and dentigerous cyst was seen.
In this case we speculate that CEOT has a potency of cyst formative nature and that the dentigerous cyst had originated from CEOT and was fused with follicle of unerupted tooth. Therefore, the rest of dental lamina is appropriate for the histogenesis of CEOT.

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A rare case of pemphigus vulgaris that occurred in a 5-year-old girl is presented. She was referred to our hospital with a chief complaint of painful and intractable erosion of oral mucosa, and this lesion was clinically diagnosed as intractable ulcerative stomatitis.
Histopathological and immunohistochemical examinations of a lip mucosa biopsy specimen revealed acantholysis of oral epithelium and presence of IgG and IgA in the intercellular epithelial region. Thus, it was diagnosed as pemphigus vulgaris.
The patient was admitted to the Department of Dermatology, Osaka University Hospital, and administered prednisolone per os at a dose of 20 rug daily. Six months after the oral manifestation, skin lesions appeared at the abdominal region. Both oral and skin lesions were markedly improved by prednisolone administration. She has no symptoms by maintaining a dose of 10mg/day of prednisolone.

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It is very important to reposition and to keep the occlusal plane in harmonious relation to TMJ and the skull in two jaw surgery. In addition, the surgery should be performed as accurately as the presurgical planning.
However, it is not always easy to satisfy the above-mentioned items in deformities indicating sagittal, transverse and vertical dysplasia or discrepancy of maxilla and mandible. For this reason, we have performed the method of intra-operative repositioning of the Le Fort I osteotomized maxilla according to the pre-operative planning by using the semi-adjustable articulator SAM or Whip-Mix facebow. We use routinely the simultaneous jaw movement by Le Fort I and sagittal splitting osteotomy for two jaw surgery.
The maxillary position determined by preplanning of the cephalometric prediction tracing and model operation is recorded with the facebow. After the recording, the facebow with the bitefork is removed from the articulator, and is sterilized with gas to be ready for the intraoperative transfer.
The maxilla is adequately mobilized as usual, the vertical dimensions of maxilla are reduced to the same extent as the model operation. The osteotomized maxilla is inserted into the bite fork. Then, the facebow is adjusted to the external auditory canal.
In addition, intermaxillary wiring is performed after the mandible is also inserted into the bitefork. Once the facebow is fixed by the nasion locator, the facebow system is kept rigid and free from distortion.
The characteristics or advantages and the indication of this facebow transfer system are as follows:
1. This system using the Whip-mix or the SAM facebow guarantees precise transfer from the articulator to the patient.
2. It has the possibility of obtaining intra-operatively accurate reproduction of the position of osteotomized maxilla in relation to the skull, the mandibular teeth arch, and the TMJ as preplanned.
3. It has the possibility of keeping the transferred position and stabilizing maxilla with the mini-plates without freehanding.
4. As this system is a “step by step” technical procedure, the laboratory workup is very important.
5. The model operation in this system is for the oral surgeon operation training.
6. The indication of this system seems to be facial asymmetry or long face with mandibular protrusion.
We have performed this facebow transfer system on 14 patients and obtained good results. All patients currently have acceptable results.

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The granular cell type is relatively rare among ameloblastoma cases. A recurrent case of this type in the maxilla is presented in this report. 10 years ago, a 24-year-old woman visited our clinic with the chief complaint of swelling in the left maxilla. This lesion was diagnosed clinically and histologically from extirpated material as a dentigerous cyst.
Recently, she visited our clinic because of tumor formation in the same area. It was diagnosed histologically as granular cell type ameloblastoma from the excised material.
Finally this lesion proved to be a recurrent case by histological findings according to the previous report.

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Renal osteodystrophy (ROD) occurs frequently in patients suffering chronic renal disease.
A 41 year-old male was referred to our clinic in order to survey the infection focus in the oral region resistance to irnmuno-depression therapy after renal transplantation. He had suffered from chronic renal failure for 11 years. X-ray examination showed a salt and pepper appearance on the mandible and disappearance of lamina dura as characteristic findings of ROD. Advanced chronic marginal periodontitis made the resorption of alveolar ridge on 7 and 8 region. These teeth indicated the need of extraction.
Then we obtained the alveolar bone through extraction of these teeth. In histopathological examination, the alveolar bone showed ostitis fibrosa with an increase of the osteoid tissue.

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A case of pilomatrixoma of the right subauricular region in a 23-year-old woman is reported along with the results of light microscopic (LM), scanning electron microscopic (SEM) and transmission electron microscopic (TEM) studies.
A solitary circumscribed stone-hard subcutaneous nodule was noted in that area for about 13 years. Sialography showed no relationship between the tumor and parotid glands. An excisional tumor was covered with a thin capsule and carefully removed with surrounding tissue. The milkwhite colored tumor was hard, solid, and fragile. There has been no recurrence yet.
LM examination revealed eosinophilic shadow cells and bone-like tissue without basophilic cells. The tumor was diagnosed as pilomatrixoma with ossification.
SEM and TEM revealed shadow cells composed of thick bundles of fibrils. Nucleus and plasma membranes disappeared and cytoplasmic organella was absent. Shadow cells were oval in shape and arranged like paving stones. Branched fibrils took the place of plasma membranes, revealing variable width and arrangements. These characteristics of the tumor suggest a long clinical course of about 13 years.

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A case of papillomatosis arising from the reconstructed skin portion following the D-P flap operation. A 55-year-old Japanese woman, who had developed a tongue cancer.
The patient was placed on an irradiation therapy (110 Gy) with a betatron and received functional neck dissection, marginal mandibulectomy, partial resection of tongue and floor of the mouth, and immediate reconstruction using D-P flap operation.
There was no local recurrence for nine post-operative years, but the fitness of the denture was loosen recently. A month after the patient had noticed the unfitted denture, the pedunculated tumor mass, lobulated and measured about 3 cm in diameter, arose from the reconstructed skin portion of the floor of the mouth.
The mass was resected but recurred three weeks later, so that re-resection and wide elimination of denture were carried out. Histopathological findings were as same as papil-lomatosis arising in the oral mucosa, except that the accessary glands of the skin were scattered in the subcutaneous connective tissue.

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We have reported five cases of malignant melanoma in the oral cavity registered between 1979 and 1989 in our clinic. Sex distribution were four males and one female.
The ages ranged from 34 to 79 years and the average was 55 years. Four cases chiefly complained of pigmentation and the other one swelling.
Sites of the tumors revealed upper gingiva and hard palate in three cases and only upper gingiva in two.
Initial treatments were performed by surgical excision of primary lesion in all cases, combination chemotherapy with DTIC, ACNU and VCR (and, or PEP, BLM) in three cases, radiotherapy in one case, and immunotherapy with OK-432 and BCG (and, or IFN-β, IL-2) in four cases.
No recurrences of the primary lesion were seen in any case. Regional lymph node metastases occurred in all cases. These metastastic lymph nodes were treated by radical neck dissection in four cases, irradiation in one case, chemotherapy in three cases, and immunotherapy in four cases. Three cases were alive at that time without local recurrence and distant metastasis. Survival time ranged from 2 years and one month to 7 years and 6 months. One case died of metastasis of the lung one year and three months after the initial treatment and another one died of systemic metastases (brain, lungs, liver, lumbar vertebra) one year and 10 months after initial treatment.
Consequently, the cases treated by chemotherapy several times showed good prognosis.
Malignant melanoma has been generally poor prognostic neoplasm because of early distant metastasis occurring with early hematogenous and lymphogenous metastases. The therapeutic results in our clinic showed that no local recurrences were seen in any case, and regional lymph node and or distant metastases occurred in all cases.
Therefore, it was considered that there was necessity for treating by early and many combination chemotherapies after operation of the primary lesion and or neck dissection in order to prevent distant metastasis of malignant melanoma.

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It is supposed to be difficult to diagnose rheumatoid arthritis in the temporomandibular joint due to the lack of diagnostic criteria for this region. Twenty-seven patients with rheumatoid arthritis accumulated in our department of out patients registration. These include seven initially involved cases on temporomandibular joint, six out of these seven suffered exclusively with the temporomandibular joint and the other is involved initially on the temporomandibular joint as well as the other joints, for example PIP, MCP, wrist joint, etc. Clinical research for rheumatoid arthritis in the temporomandibular joint was subjected to these twenty-seven patients, and the possibility of the diagnostic criteria was discussed.
Clinical symptoms and radiographic findings are the most important aspects to diagnose this lesion. Crepitus, slight disturbance of mouth opening, pain on jaw functions, and temporomandibular joint stiffness are common clinical symptoms. Xerostomia and anemic complexion and/or color of gingiva are frequently found as the symptoms in the maxillofacial region except the temporomandibular joint area. On the radiographic findings of the temporomandibular joint, resorption on condylar head, fossa, and tubercle as well as faint and narrowed joint space are specific to this lesion. Heat accumulation on the temporomandibular joint area of bone scintigraphy are always recognized. As the referable items to this lesion, seropositive reaction of RF, high content of Gam.rnar Globulin, Ig-G, TTT, ZTT, CRP, and acceleration of BSG are generally found in rheumatoid arthritis. Swelling, pain, stiffness, deformity, and abnormalities on radiographic films of the other joints are also helpful to diagnose this lesion. Miscellaneously, predominanly adult women would visit our clinics with complaints related to the temporomandibular joint, i.e. pain in this region, and with xerostomia. The premonitory symptoms of rheumatoid arthritis could be also experienced with the initial involvement in the temporomandibular joint.
This research succeeded to throw light upon the diagnostic items for rheumatoid arthritis in the temporomandibular joint. In the next step we are going to establish d. diagnostic criteria for this lesion, increasing the cases and calculating sensitivity, specificity, and accuracy of these items.

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4 p-syndrome (Wolf-Hirchhorn syndrome) is a rare congenital abnormality, characterized by delayed growth and development and facial dysmorphism associated with partial deletion of the short arm of chromosome 4 (4p-). Among many clinical findings, cleft lip and/or palate are the major manifestations. This is the case report of a male infant with 4p-syndrome, including a bilateral cleft lip and palate. Physical examination showed severe growth retardation, seizures, deafness, multiple craniofacial defects including a bilateral cleft lip and palate, inguinal hernia, hypoplastic dermal ridges, and so on. Roentgenographic investigation revealed dysplasia of the permanent dentition. Cytogenetic studies showed that the short arm of chromosome 4 was deleted and the band 4p 15.32 or 4p 15.33 was broken, although both parents had normal karyotypes. These findings are common features of this syndrome.
Repairs of the bilateral cleft lip and palate were performed at the age of 9 months, 1 year and 4 months, and 3 years and 4 months, respectively. The postoperative course was good.
Operations on cleft lip and/or palate for 4p-syndrome patients without serious complications are thought to be generally possible, although careful consideration is required.

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Eight cases of basal cell nevus syndrome (BCNS) are reported with a review of 95 cases in the Japanese literature. In contrast to equal sex distribution in the literature, the male to female ratio in our cases was 6 to 2. Five patients were in the 2nd decade and 3 in the 5th decade. Including our patients, the mean age of the patients in the literature was 24 years. Multiple jaw cysts were seen in 82.0% of them, which was followed in order of frequency by ocular hypertelorism (79.6%), frontal and parietal bossings (69.9%), calcification of the falx cerebri (66.0%), pits of hands and feet (63.1%) and so forth. The presence of jaw cysts which included 31 primary cysts and 10 recurrent cysts with or without multiple recurrences was also constantly found in our patients. All but one had multiple cysts. Of the 31 primary cysts, 21 occurred in the mandible and 10 in the maxilla.
Radiographically, the cysts were unilocular in 32 cysts (78%), unilocular with marginal scalloping in 5 cysts (12%) and multilocular in 4 cysts (10%). The primary cysts were accompanied by unerupted teeth in 11 cysts (35%) and congenitally missing teeth were found in the affected area in 12 cysts (40%). The latter findings were characteristic of the cysts associated with BCNS. Excluding 3 untreated cysts, marsupialization alone, marsupialization followed by enucleation, and enucleation and primary closure or packing open were performed respectively for 9 (32%), 4 (14%) and 15 (54%) primary cysts. Of 27 primary cysts with at least 6 months follow-up, recurrences were noted in 7 cysts (26%) during the period of 10 months to 12 years and 10 months postoperatively. In all cases the recurrences were found in patients in the 2nd decade. The rate of recurrence was significantly higher in cysts with unerupted teeth. The failure to remove the cysts in one piece seemed to be the potential factor leading to recurrence. Histologically, the presence of epithelial islands and/or daughter cysts were observed in 13 cysts (34%) and mitotic figures seen in the basal layer of the lining epithelium was 1.2/5 HPF.

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This research was designed to find out postoperative complications in relation to intermaxillary fixation (IMF) after maxillo-facial surgery by questionnaires sent to 141 hospitals, which performed oral surgery, throughout nation. We obtained 113 replies (87.9%).According to them, 11, 017 operations were carried out under general anesthesia, including 2, 315 cases with I IF (20. 1%). IMF was performed during the intraoperative period in 55 hospitals (50%), on the other hand, 46 hospitals (40%) had done IMF in the postoperative period. Several major complications, like pneumonia or pulmonary edema, were reported in addition to minor complications, like vomiting or hemorrhage, in the answers of 36%of the hospitals.
These results indicate that guidelines on the management of patients with INIF are required in order to accomplish safe treatment in the perioperative period.

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Myoepithelioma is a rare salivary gland neoplasm. Histologically, the tumor is composed of spindle-shaped and/or plasmacytoid cells.
Plasmacytoid myoepithelioma of the soft palate was reported in a 53-year-old man. The tumor, measuring 35×25×5 mm, was located on the left side of the soft palate and was surgically removed. Two years later, the patient has not experienced recurrence.
Microscopically, the tumor consisted of plasmacytoid cells with round eccentric nuclei surrounded by an abundant homogenous eosinophilic cytoplasm in myxoid stroma.
Immunohistochemical studies revealed positive reactions for S-100 protein and vimentin in tumor cells. Electron microscopy demonstrated abundant intermediated filaments filled with tumor cells.
A review of the literature indicated that plasmacytoid myoepitheliornas appearred to have a predilection for the oral cavity in younger individuals, while the spindle-cell form tends to occur in the parotid gland in older patients.

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