The following results were obtained for the development of the upper lip and the pathogenesis of cleft lip based on studies using whole embryo cultures of A/WySnj mouse from D. 11. 5 (T. S.=19) for 24 hours.
1. Complete cleft lip occurred in embryos with underdeveloped facial prominences and a long distance between prominences.
2. Complete cleft lip occurred in embryos with a deep nasal groove due to tearing off of the nasal groove.
3. Incomplete cleft lip occurred in embryos with a normal nasal groove and a short distance between facial prominences.
4. Normal primary palates resulted in the development of a normal upper lip or an incomplete cleft lip with a persistent labial groove between the medial nasal and the maxillary prominences.
5. These results suggested that the pathogenesis of cleft lip is due to insufficient development of the facial prominences. Early onset of underdevelopment resulted in a severe cleft lip, while later onset resulted in a mild cleft lip.

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Versican-like large proteoglycan and tenascin are extracellular matrix (ECM) components which are thought to contribute to the control of cell behavior during embryonal development especially in neural crest cell migration and differentiation, cartilage development, and central nervous system histogenesis. Since these ECMs are also appear in a certain human malignant tumour, tliese are thought to be oncofetal ECMs. In present study, the immunohistochemical distribution of versican-like large proteoglycan and tenascin was investigated in 70 human tongue cancers (squamous cell carcinoma) and 19 radical neck dissection cases with regards to the histological degree of malignancy, biological degree of malignancy evaluated by the staining of Ki-67 antigen, p 53 protein expression, and with or without evidence of regional lymph node metastasis.
The expression of chondroitin sulfate, versican-like large proteoglycan, and tenascin on the specific stroma of human tongue cancer increased according to the high-malignant grade of differentiation, mode of invasion, and histological malignancy grade of it. These expressions were also related to the Ki-67 antigen expression of cancer cells. The expression of p 53 protein of cancer cells was related with that of versican-like large proteoglycan, but not with tenascin. In primary lesions with regional lymph node metastasis, the expression of chondroitin sulfate, versican-like large proteoglycan, and tenascin had a tendency to increase more than those without metastasis. The same expressions were seen on metastatic lesions of regional lymph node.
These results suggest that versican-like large proteoglycan and tenascin on the stroma of human tongue cancer may play a role in the tumour progression as a promotive factors.

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The presence of lymph node metastasis plays a predominant role in determining the prognosis of a patient with squamous cell carcinoma of the tongue. Therefore, it is very important to investigate the factors associated with lymph node metastasis. In this study, histological and immunohistological analyses were performed to evaluate the clinical and pathological factors which are important in cervical lymph node metastasis. Factors such as tumor size, mode of invasion, stage of invasion, cellular response and distribution of extracellular matrix were found to be significantly related to cervical node metastasis.

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This study assessed the antitumor effects of local administration of interleukin-2 (IL-2) and/or interferon-β on mouse-syngeneic transplantable plasmacytoma X 5563. When the tumor reached a palpable size of 5 to 10mm in diameter, the mice were divided into four groups: IL-2 alone, IFN-β alone, a combination of IL-2 and IFN-β, and a control group. 35, 000 JRU of IL-2 and 100, 000 U of IFN-β were administered intratumorally every day for ten days. Tumor growth was inhibited partially in the IL-2 alone group and in the IFN-β alone group. The tumor disappeared in only 1 of 13 mice in the IFN-β alone group and in none of the mice in the IL-2 alone group. On the other hand, the combination of IL-2 and IFN-β produced a significant reduction in tumor size and the tumor disappeared in 24 of 26 mice. The rate of metastasis to the inguinal and/or axillary lymph nodes was 33.3% in the IL-2 alone group, 38.5% in the IFN-β alone group, and only 7.7% in the group receiving a combination of IL-2 and IFN-β. Compared with the control group, treatment with IL-2 or IFN-β alone did not prolong survival whereas survival was significantly longer in the group given combined treatment than the other three groups.
Histologically, infiltration of many mononuclear cells and neutrophilic leucocytes was seen around tumor tissues only in the combination group. The mononuclear cells reacted with Thy 1.2 and Lyt-2 antigen predominantly.
Although NK activities of spleen cells were enhanced significantly in the three experimental groups compared with the control group, LAK activities were not enhanced. Cytotoxic activities against X 5563 were induced only in the combination group. In vivo and in vitro studies using the anti asialo-GM 1 antibody revealed that, since asialo-GM 1 negative cells had cytotoxic activities against X 5563, the involvement of NK cells in the antitumor effect of combined treatment with IL-2 and IFN-β was minimal. The administration of IL-2 and IFN-β augmented MHC class I antigen expression on X 5563 cells compared witht the primary cells.
These facts suggest that the antitumor effect of combined treatment with IL-2 and IFN-βinvolves T cells rather than NK cells. Combination therapy with IL-2 and IFN-β seems to be a new useful immunotherapy for oral cancer.

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This study used 1.5 Tesla magnetic resonance imaging (MRI) to evaluate the positional and morphological changes of the disc and condyle in patients with closed lock treated nonsurgically. A total of 20 joints (19 patients) which were successfully unlocked by nonsurgical treatment were studied. Nonsurgical treatment was gradually applied a fbllows: 1. mandibular manipulation, 2. anterior splint assisted manipulation, 3. pumping manipulation, 4. stabilization splint therapy. The joints were evaluated by MRI in the closed-and open-mouth positions before and after treatment. Posttreatment MRI was also performed with the splint in place. Each imaging procedure was made in the same sagittal plane.
After treatment, 19 patients experienced significant improvement in pain, range of motion, and mandibular dysfunction. Post-treatment MRI revealed that only one joint was normal. Six joints had anterior disc displacement with reduction (DWR), and 13 joints had anterior disc displacement without reduction (DNR). Evidence of disc repositioning with the splint in place was seen in 4 joints in the DWR group. Disc mobility increased with improved condylar translation in 19 joints. Disc deformity progressed in 10 joints of the DNR group.
These results suggest that successful treatment for internal derangement with closed lock may require an increase in the mobility of the disc, regardless of disc position.

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Clinical statistics were collated for 212 cases of facial fracture at the First Department of Oral and Maxillofacial Surgery, Kyushu University Dental Hospital during the 3 years from 1989 to 1991. The data were then compared with those obtained for 1429 cases of facial fracture during the 17 years from 1962 to 1978, already reported, concerning sex ratio, age, causes, period from injury to presentation, associated injuries, etc.
1) The ratio of females had markedly increased.
2) The ratio of teen-age patients had increased.
3) The ratio of work-related accidents had decreased, while that due to assaults had increased.
4) The incidence of cases presenting at hospital 2 or more weeks after injury had markedly decreased.
5) The incidence of cases with severe head injury associated with facial fractures had decreased.

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Production of the wire structure for speech-aids demands a high degree of skill. In this study, we determined the wire structure for speech-aids, using lead foil and cephalometric radiograms. In the region of the soft palate, the wire structure was decided using lead foil, and in the region of the velopharyngeal space, the structure was decided using cephalometric radiograms. Such techniques can be mastered readily by relatively inexperienced individuals.

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Actinomycosis shows typical symptoms of plate-like induration, multiple smaller abscess formation, and trismus. Recently, we seldom, if ever, find typical cases due to the ealy initiation of short-term antibiotic therapy. We report a patient with actinomycosis with relatively typical symptoms, which occurred at the right mandibular angle. An 18-yearold male underwent extraction of the right lower third molar at a dental clinic because of suspected pericoronitis. However, 1.5 months later, he was referred to our clinic because of marked trismus, swelling, fever, and tenderness of the same mandibular angle. At initial examination, relatively clearly demarcated redness, a hot sensation, and tenderness were found at the affected region. Surrounding the redness, induration was present, and a wavy sensation was palpated in the central region. Histopathological examination of granules in the fluid revealed the presence of Actinomyces.

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Necrotizing sialometaplasia is a benign circumscribed ulcerative inflammatory condition of the minor salivary glands of the oral cavity. It is often mistaken clinically and histopathologically as a malignancy, such as squamous cell carcinoma or mucoepidermoid carcinoma.
A 17-year-old Japanese female was referred to our hospital complaining of bilateral nonulcerated swellings of the plate. Biopsy samples taken from both lesions revealed histopathological signs of necrotizing sialometaplasia. Both lesions completely healed without treatment 10 weeks after biopsy and there was no evidence of recurrence.
Recognition of necrotizing sialometaplasia, regardless of its clinical or microscopic presentation, is essential to avoid inappropriate or unnecessary treatment of this benign reactive lesion.

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A 2-year-old boy with an ameloblastic fibro-odontoma in the mandible is reported.
The boy was referred to our department for painless intraoral swelling. Standard radiographs showed a mixed radiolucent-radiopaque mass at the right mandible. It was decided to extirpate the focus under general anesthesia. The tumor consisted of dense tissue with scattered, small calcified foci. Histopathologically, it was diagnosed as an ameloblastic fibroodontoma.

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In this paper, three cases of acute suppurative arthritis of the temporomandibular joint, occurring in a 65-year-old man (case 1), 40-year-old woman (case 2), and 67-year-old woman (case 3), are presented.
Clinical signs and symptoms were general malaise, pyrexia, trismus with localized swelling, tenderness, waviness over the left temporomandibular joint, and malocclusion with deviation of the mandible to the healthy side.

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The authors describe their technique for correcting a cleft lip nasal deformity using the open method, which allows easy and precise correction. Repositioning of the displaced lower lateral cartilage on the cleft side is performed to raise the dome. The deviated septal cartilage has to be completely removed to eliminate obstruction of the nasal airways. The harvested septal cartilage is trimmed and placed as a columellar strut to reshape the down wardly displaced nasal tip and alar wing. Open method rhinoplasty is the best way to perform these procedures. In the severely deformed cleft-lip nose, the cantilever bone graft technique is used for additional structural support. Augmenting the nasal bridge creates the illusion of a narrower nose. The cantilever technique is also performed under the direct vision.

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The author reports a 31-year-old man with a chondroid syringoma on the upper lip. Histopathological examination showed that the tumor cells were arranged in one or two layers with a solid or trabecular pattern. In the stroma, myxomatous or chondroid structures were seen.

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Benign cementoblastoma is a tumor of the cementum that occurs in connection with dental root. It is believed to be a very rare lesion. We encountered a benign cementoblastoma at the root 6 in a 24-year-old male, and the extracted mass was examined for calcification (calcium and phosphorus) by a CMA (computer-aided microanalyser).
There was a tendency towards a higher distribution of calcium and phosphorus in the center of the mass than in the periphery.
The weight percentages of calcium and phosphorus in the mass were higher than in normal cementum.

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This is a case report of a patient with an intraosseous carcinoma of the mandible. The patient was a 49-year-old female with a chief complaint of right mandibular angle swelling. The right retromolar pad was tender and slightly swollen, whereas the overlying mucosa was intact. The orthopantomograph revealed an impacted wisdom tooth with an associated pericoronal radiolucency. The clinical diagnosis was an odontogenic cyst. The impacted wisdom tooth was therefore removed and marsupialization was performed. The histological diagnosis was an infected dentigerous cyst. Three months later, her right mandibule became swollen again. The histological diagnosis was hyperplasia of the lining epithelium with severe dysplasia. However, this time we hiopsied the deep sites of the cavity, and obtained a pathological diagnosis of squamous cell carcinoma.
These results indicated that the lesion was an intra-osseous squamous cell carcinoma arising from an odontogenic cyst.

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A 4-day-old female with a Tessier No.3 facial cleft on the left was accompanied to us. Her cleft arose from left medial canthus, ran downward obliquely through medial side of the lachrymal point and the nasolabial groove along the lachrymal fissure, turned round the alar base and went into the nasal floor linking with the cleft lip, the alveolar cleft and the cleft palate. Complete defect of the maxillary frontal process was observed. She was bilateral microphthalmia and had no visual acuity, too. The plastic operation for the facial cleft was performed 6 months after birth. The Cronin's method was applied similarly for the lip, the buccal cutaneous flap was rotated and advanced for the facial cleft, and the Z-plasty was applied on the eyebrow to improve the lower displacement of medial canthus.

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Neurofibroma which is often multiple is one of the symptoms of von Recklinghausen's disease. Solitary development of neurofibroma in the oral cavity is rare. We encountered a patient with a solitary neurofibroma that occurred on the gingiva. The patient was a girl aged one year and one month. She was introduced to our department due to swelling of the upper median gingiva. A swelling was detected in the cervical gingiva labially to the left upper deciduous central incisor. It was smooth on the surface, semi-spherical and elastic, and measured 5 mm in diameter. The swelling was clinically diagnosed as an epulis and was surgically excised under general anesthesia two months later. The resected lesion was spherical and not clearly encapsulated. Hyperplasia of small, thin collagen fibers mixed with fibroblasts was histologically found. The lesion seemed to be neurogenic. It reacted positively to immunohistochemical staining with S-100 protein.

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Calculi of the parotid gland are rare. Recently, we encountered a patient with a calculus in the parotid gland and performed structural analysis of the calculus, compared to calculi in the submandibular gland, by scanning electron microscope (SEM), transmission electron microscope (TEM), X-ray microanalyzer and X-ray diffractor.
The patient, a 60-year-old female, visited our clinic with the chief complaint of a strange feeling in the right parotid gland. CT scan examination revealed a stone in the parotid gland duct, which was removed under general anesthesia.
By X-ray microanalyzer, the detected component elements in calculi were Ca, P, S, Mg, Na, etc. X-ray diffractor and TEM revealed the presence of hydroxyapatite. SEM examination showed a granular or globular structure on the surface of the calculus. Cocci and filamentous microorganisms were seen on the surface. From these investigations, it was difficult to clarify structural differences between calculi in the parotid gland and those in the submandibular gland.

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