The purpose of this study is to evaluate the role of hydroxyapatite (HA) in the process of osteogenesis. Composite grafts of HA (particles and porous column) and autogenous calvarial periosteum were implanted into the back muscle of 12 rabbits. HA alone and periosteum alone were also implanted as control. Three and 6 months after implantation, the grafts were retrieved and evaluted histologically and microradiographically. There was no significant difference between 3-and 6-month implant periods in any implant group.
No calcified tissue was formed when HA alone (both particles and porous column) was implanted. Minute calcified tissues were scattered in the histologic and microradiographic specimens of periosteum alone or particulate HA/periosteum grafts. On the other hand, bone tissue was noted in the specimens of porous-columnar HA/periosteum grafts. Bone tissue was seen only inside of the pores where it adhered intimately to the HA wall of the pores.
Although the role of HA in the osteogenic process was not defined in this study, it is very interesting that different calcified tissues were induced by the particulate and porouscolumnar HA/periosteum grafts.

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We have established a new cell line derived from a small cell carcinoma of the gingiva which supposedly metastasized from lung cancer. We examined its biological characteristics by flow cytometry (FCM), fluorescence in situ hybridization (FISH) using DNA specific probes, and immunohistochemical staining of neuron specific enolase (NSE). The original tumor cells consisted of middle-sized cells and showed NSE positive immunostaining. The DNA indexes (DI) measured by FCM, showed peaks at 1. 1 and 1. 6, both of which indicated DNA aneuploidy. After being transplanted to nude mice, the tumor cells became larger and showed intercellular bridges and less keratinization similar to squamous cell carcinoma cells. Although the transplanted tumor cells underwent morphological changes to squamous cell carcinoma-like cells, they maintained their original characteristics as indicated by NSE positive immunostaining. DI of the cell line was about 1. 3 and chromosomal analysis revealed that the modal chromosomal number was 48. Numerical chromosome aberrations were detected by FISH methods using centromere-specific DNA probes against chromosomes 1, 4, 11, 17, and trisomy of chromosome 17 tended to be higher than other chromosomes in this cell line.

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The expression of cathepsin B, D and G in squamous cell carcinoma of the oral cavity was immunohistochemically investigated. Both cathepsin B and D were demonstrated in tumor cell cytoplasm and their distribution patterns were comparable in each case. However, the expression of cathepsin G was weaker than that of cathepsin B and D.
We tried to classify the cathepsin expression of tumor cells into three groups according to the intensity of cathepsin B stainability, which showed up most clearly. Using this grouping, cathepsin B expression was found to be significantly related to lymph node metastasis and the mode of the basement membrane, although there was no clear relationship with tumor extent and histological grade of malignancy.
These results suggested that the expression of cathepsin B and D might be related to the destruction of the basement membrane and the progression of lymph node metastasis.

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It has been reported that combination chemotherapy with cisplatin (cis-diamminedichloroplatinum (II), CDDP) and 5-fluorouracil (5-FU) shows synergistic cytotoxicity against both murine and human neoplasms. CDDP plays an important role as an effector as well as a modulator in biochemical modulation of 5-FU. Tegafur (1-(2-tetrahydrofury1)-5-fluorouracil, FT-207) is synthesized as a masked form of 5-FU possessing antitumor activity. This compound is gradually converted into 5-FU in vivo. There have been no reports of combination chemotherapy with CDDP and FT-207 on the histological changes in squamous cell carcinoma of the head and neck. The aim of this study is to investigate the possibility of CDDP and FT-207 synergistic antitumor effect on tongue cancer induced by 4-nitroquinoline 1-oxide in rats.
Tumor bearing rats were treated by four different regimens:(1) CDDP single infusion;(2) FT-207 5 day infusion;(3) CDDP single infusion and FT-207 5 day infusion;(4) no treatment as a control. The following results were obtained. Macroscopic response rates (the tumor showed evidence of regression) to each of the three chemotherapy were 0%, 10% and 50% in groups (1), (2) and (3), respectively. Histological response rates (the tumor showed evidnce of Grade I or above) were 10%, 40% and 100% in groups (1), (2) and (3), respectively. The antitumor activity was enhanced synergistically by the combination of CDDP and FT-207 infusion as compared with that of treatment with each drug alone. Macroscopic type and the mode of invasion were correlated with the antitumor effect both macroscopically and histologically. Therefore, macroscopic type and the mode of invasion can be important factors in forecasting the effect of treatment when combination chemotherapy with CDDP and FT-207 is carried out. The ³H-thymidine labeling ratio decreased markedly after the combination therapy with CDDP and FT-207. ³H-thymidine labeling ratio were higher in tumors showing invasive types such as 4C or 4D (Yamamoto and Kohama) than in those showing 1.2 or 3 invasive types and this tendency was maintained after administration of antitumor agents.

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In order to elucidate the healing process of vascularized bone grafts, a bone defect was prepared on the mandible of adult dog. Bone was taken from the tibia together with the nutrient saphenous artery and vein, and was grafted by microvascular anatomosis. A nonvascularized bone was grafted on the contralateral site as control, and the healing process was observed over time by H-E stained and fluorescent labeled specimens.
1. In the vascularized bone grafts, transient inflammatory changes were noted initially but subsided after 2 weeks. At the junction between the grafted and existing bone, there was some difference in the amount of bone formation, compared with the non-vascularized bone grafts. After 4 weeks, the morphology of the grafted cortical bone was maintained, and briding was noted at the junction. The graft bone and lateral region of underlying bone became transitional after 8 weeks. Furthermore, it became impossible to recognize the junction after 24 weeks, and almost no change was noted up to 48 weeks.
2. The bone grafts maintained their original morphology in the initial stage, but after 2 weeks, necrosis and resorption of bone occurred from immediately below the graft bone. After 4 weeks, bone formation was mostly derived from the underlying bone, and no bridging was defected. After 8 weeks, the graft bone itself was absorbed, and the new trabecular bone derived from the underlying bone circumscribed the grafted site. Furthermore, maturation of trabecular bone continued even after 24 weeks, and the morphology of cortical bone was found after 48 weeks.
3. In vascularized bone grafts, signs of labeling were recognized from immediately after the operation and became most remarkable after 4 weeks. However, after 8 weeks, slight signs of labeling image were merely seen at the junction. On the other hand, in the nonvascularized bone grafts, labeling was confirmed for the first time after 4 weeks, and continued up to 24 weeks.
4. The results suggest that vascularized bone grafts effectively adhered to the underlying bone without changing the outer from by maintaining the activity of the graft bone itself from immediately after the operation. On the other hand, non-vascularized bone grafts were gradually absorbed, finally providing the contour of the mandible, but required much more time for the bone remodeling process compared with the vascularized bone grafts.

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This study investigated two different culture systems used to obtain effective lymphokine activated killer (LAK) cells for adoptive immunotherapy (AIT). These LAK cells Were induced from peripheral blood mononuclear cells derived from early (stage I and II: UICC) and advanced stage (stage III and IV: UICC) head and neck cancer patients and compared with cells derived from healthy volunteers which served as control.
One culture system utilized only recombinant interleukin-2 (rIL-2 system). The other culture system utilized rIL-2 with anti-CD3 monoclonal antibody (rIL-2+ aCD3moAb system). Induction of LAK cells was evaluated by measuring proliferation, cytotoxicity (NK and LAK activity) and cell surface phenotypes at various culture periods (0, 2, 3, 5, 7, 10 and 14 days) in the two different systems.
The rIL-2+ αCD3moAb system induced an approximately 10-fold increase in cell number compared to the rIL-2 system. Although there was no statistically significant difference, the number of LAK cells derived from cancer patients (early and advanced stage) was less than that derived from healthy volunteers in both culture systems.
Of the culture periods evaluated, 5 to 7 days provided the highest level of LAK cell cytotoxicity in the rIL-2 system while 3 to 5 days yielded the highest cytotoxicity in the rIL-2 +αCD3mAb system.
In addition, maximum cytotoxicity (NK and LAK activity) of LAK cells dervied from cancer patients (early and advanced stage) was delayed for 2 days compared with that of LAK cells derived from healthy volunteers. Although LAK cells from early and advanced stage cancer patients showed a similar time delay in reaching maximum cytotoxicity, the degree of cytotoxicity was lower in the advanced stage patients.
LAK cells induced by the rIL-2αCD3moAb system showed a decrease in cytotoxicity compared with those induced by the rIL-2 system. However, the rIL-2 αCD3moAb system induced higher total cytotoxicity % cytotoxicity ×number of LAK cells, than the other system.
After elimination of CD8+ cells from LAK cells induced by the each system, cytotoxicity (NK and LAK activity) increased in the rIL-2 +αCD3moAb system, but decreased in the rIL-2 system. Therefore, the functions of the CD⁸⁺ cells induced by these two distinct culture systems were suggested to be different.
These results suggest that AIT using LAK cells should be indicated in the treatment of early-stage cancer patients.

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Fourteen cases of malignant lymphoma (ML), diagnosed in our depratment over 26 years from 1965 to 1991, were examined clinically, focusing mainly on the intial symptoms. The results were as follows:
1) ML Accounted for 4. 5% of all oral malignant tumors.
2) The patients consisted of 10 males and 4 females. The majority of them were advanced in age.
3) There were 5 nodal cases (35. 7%) and 9 extranodal cases (64.3%).
4) In all 5 nodal cases, the initial lesion involved the neck and/or submandibular lymphnodes. In the externodal cases, 3 cases appeared in the gingiva, 2 in the maxillary sinus, 2 in mandibular bone, 1 in the cheek, and 1 in mandibular bone and the front of the ear.
5) Swelling was the initial local symptom in all cases.
6) The initial clinical diagnoses in the 14 cases were malignant lymphoma in 1 case, malignant tumor in 8 cases, benign tumor in 3 cases, inflammation in 1 case, and inflammation and tumor in 1 case.
7) In X-ray examinations, the nodal cases showed no abnormal images. In the extranodal cases, 2 cases with maxillary sinus lesions showed radiopaque areas, and 2 cases with gingiva lesions and 3 with mandibular lesions presented bone destructive changes.
8) ML was suspected in 1 of 5 cases by CT examiation and in 4 of 6 cases by ultrasound examination.
9) Laboratory examinations indicated cases with high LDH values tended to have a poorer prognosis.

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This paper deals with cell kinetics and the correlation between proliferating cells and phenotype expression in mucoepidermoid carcinomas. Ten patients who had been treated at the Department of Oral and Maxillofacial Surgery II, Okayama University Dental School, during the last ten years, were selected for this study.
Immunohistochemical studies of proliferating cells and the phenotype of tumor cells were performed using anti-proliferating cell nuclear antigen (PCNA), CEA, muscle actin, S-100, lactoferrin, secretory component and total keratin antibodies.
The PCNA labelling index (L.I.) of mucoepidermoid carcinomas was higher than that of normal salivary gland tissues, and correlated with tumor differentiation.
The proliferating activity of tumor cells in the capsule was little higher than that in the nests of the tumors. Localization of muscle actin, lactoferrin and total keratin was frequently detected in PCNA positive cells, but that of CEA and secretory component was not demonstrated in them.
These results indicated that CEA and secretory component were objective markers for the functional differentiation of mucoepidermoid carcinomas.

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Many treatments have been recommended for the management of hemangiomas. However, postoperative esthetics and function of the organs are often the problems for lesions in the oral and maxillofacial region. Absolute ethanol is an effective agent in the treatment of hemagiomas which may not be resectable.
Two patients with hemangiomas in the oral and maxillofacial region which were treated by direct ethanol injection are described. Case 1 was an 82-year-old female with a cavernous hemangioma of the mouthfloor. Case 2 was a 64-year-old female with a venous angioma of the cheek. Both patients were admitted to our hospital because of gross swelling.
However, resection of these extensive hemangiomas would most likely lead to gross disfigurement and dysfunction. We therefore tried direct ethanol injection therapy. Initially the lesions demonstrated a reactive inflammatory edema which was followed by slow resolution over several days with subsequent mild fibrosis. The lesion in case 1 required 4 ethanol injections (2ml×4) during 4 months, and the lesion in case 2 was controlled solely by a single injection (5ml). Direct ethanol injection therapy provided the greatest opportunity for preserving the surrounding normal tissue and obtaining improved cosmetic and functional results.

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This retrospective study about trismus after the release of maxillomandibular fixation was performed in 103 cases of mandibular fracture in our department and the following results were obtained:
1. Most cases of trismus were recovered by 12 weeks after the relase of fixation. However, in the group below the age of 30 years recovery took place within 8 weeks.
2. Trismus was most frequently found in multiple-line fractures.
3. Trismus occurred less frequently in open reduction cases than in closed reduction cases.
4. The relative frequency of trismus was unaffected by the presence or absence of condylar fracture.
5. There was no definitive relationship between the period of maxillomandibular fixation and the occurrence of trismus.

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Frey's syndrome is a complication of parotid gland surgery. We reported a method for preventing Frey's syndrome following parotid gland surgery and evaluated its effect.
Thirteen parotid gland tumors were operated on. They included 10 benign tumors or tumor-like lesions and 3 malignant tumors.
The operative defects after superficial or total parotidectomy were covered with superiorly based muscular flaps from the sternocleidomastoid in 10 cases. The operative defect after a deep lobectomy was covered with an inferiorly based fascial flap from temporal muscle in one case. Lyophilized human dura was inserted between the operative defect and the skin flap in two cases.
Frey's syndrome was noted in two cases.

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Pycnodysostosis is a rare hereditary bone disorder characterized by dwarfism, cranial suture insufficiency, mandibular angle loss and maxillary hypoplasia.
This report describes a case of pycnodysostosis complicated by osteomyelitis of the jaws in a 63-year-old woman.

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A case of metastatic thyroid cancer of the right mandible which had metastasizedto the ribs, thoracic vertebrae, lumbar vertebrae, sacrum, ilium and lung is presented. The first pathological diagnosis was clear cell carcinoma, metastatic to the mandible. The patient was given chemotherapy and radiation therapy. In spite of therapy, the metastatic tumor did not disappear between 1981 and 1990.
Of great importance was that pathologically the metastatic tumor changed from a low malignancy to high malignancy anaplastic carcinoma. Moreover, samples of the mandible and ilium which were collected at autopsy showed positive reactions to anti-human thyroglobulin antibody in immunohistological staining.

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Intra-and postoperative management of patients with holoprosencephaly is very difficult due to great variations in blood pressure and/or body temperature conbined with respiratory problems.
Case report: The patient was a female with holoprosencephaly type IV complicated by cleft lip and Palate VSD, diabetes insipidus, hypernatremia and respiratory problems. Plastic surgry of lip was performed at the age of 11 month.
Anesthesia was introduced after fentanyl citrate and diazepam i.v. with no premedication, and the operation was done under oxide/fentanyl citrate/enflurane anesthesia. During the operation, central, peripheral and rectal temperatures were monitored.
During and after the operation, variations in body temperature were great, but other vital signs and serum electrolytes were stable.

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A case of multiple facial trauma associated with aortic valve rupture is reported. A 47-year-old male, who suffered multiple facial trauma in a traffic accident, showed aortic regurgitation. After the congestive heart failure was controlled, open reduction and rigid fixation of the facial bone fracture was carried out with mini-plates and wires. On postoperative day 22, aortic valve replacement was performed. The patient's course was uneventful and he was discharged on postoperatively day 28. He has been very well, except for slight TMJ pain, possibly due to the confusion of the mandible for the past 5 years.

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A case of necrotizing sialometaplasia in the right side of the hard palate is presented. The patient was a 52-year-old male. He complained of an ulcer in the right side of the hard palate. He had a history of acute stomatitis caused by inhalation of chlorine gas one month before. A histopathological examination diagnosed this ulcer to be necrotizing sialometaplasia. The wound healed in 8 weeks by ample irrigation and steroid application, and there was no recurrence of the lesion.

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A case of an elongated uvula is reported. The patient was a 78-year-old female. She complained of on abnormal sensation of the pharyngolaryngeal region elicited by touching the uvula with the tongue. No other abnormality was observed in the pharyngolaryngeal region. This uvula was like a string and measured 40 mm. Her complaint disappeared after resection of the uvula.

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An extensive hemangioma in the face of a 36-year-old woman was successfully managed by pure magnesium sclerosing therapy. A total of 53cm of pure (99.8%) magnesium wire, 0.5mm in diameter, was inserted into the tumor in four times over 15 months. Although no reduction of the mass was observed, the sclerosed tumor was easily separated and removed. The sclerosing effect on the tumor minimized bleeding and facial nerve injury could be avoided. Pathological examination showed the formation of thrombi and dense collagen fibers, confirming the sclerosing effect.

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A case of drug-induced esophageal ulcer caused by cefotiam hexetil hydrochloride is reported. The patient was a 65-year-old man. He took cefotiam hexetil hydrochloride tablets after extraction of the third lower molar. Dysphagia developed on the day following drug intake. Esophagoscopy revealed superficial ulcers in the Middle part of the esophagus. He was treated with an H2-blocker and antiacids and his symptoms disappeared 1 week after onset. The acute presence of these ulcers was attributed to the large size of the tablets and swallowing difficulty occurring after tooth extraction.

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Adenomatoid odontogenic tumors account for about 2% of all odontogenic tumors. This tumor occurs mostly in the maxillary incisor region of young females and is rare in the mandibular molar region.
An adenomatoid odontogenic tumor arising at the mandibular second molar region in a 19-year-old male is reported. The tumor and mandibular second molar impacted just under it were extirpated under local anesthesia. The lesion measured 15×10×10mm and was of soft elastic consistency. Its surface was smooth and whitish-gray in color. Histological investigations revealed an adenomatoid odontogenic tumor with tiny calcified particles which resembled dentin or cementum.
Reccurence has not been noted as of 1. 5 years after the operation.
The authors believe this to be the first case report of an adenomatoid odontogenic tumor located at the second molar region of the mandible.

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Most central fibromas are of odontogenic origin, while those of non-odontogenic origin are rare. Furthermore, desmoplastic fibromas of the jaw bones are very rare.
Recently, we encountered a desmoplastic fibroma occurring in the anterior region of the mandible of a 37-year-old male patient. Radiological examination revealed a walnut-sized region of unicystic radiolucency. For treatment, partial resection of the mandible, including the tumor, was performed. Histopathologically, the tumor tissue was composed of dense collagen fibers and fibroblasts. Calcifying tissue and odontogenic epitheilum were not noted.
The prognosis was fairly good after surgical treatment and there are no signs of recurrence at present.
We reported this case together with some comments based on the literature.

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