The fertilized ovum of an animal model with spontaneous cleft lip and/or palate was transferred to an animal model that does not develop cleft lip or palate.
Fifty-two fetuses were obtained by transferring the ovum of A/J strain mice to the uterus of C57BL/6 strain mice. Cleft lip and/or palate and other external malformations were not found in the fetuses by examination with a stereoscopic microscope.
The results suggest the need to reconsider ovum transplantation for the prevention of cleft lip and/or palate.

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Assessment of the distribution of lymphatic capillaries in the connective tissue underlying tumors is very important when attempting to explain the mechanism by which cervical lymph node metastases arise from tongue cancer. The left lateral border of the hamster tongue was rubbed with a dental cleanser in the control group. In the experimental group, it was further treated with a 2.0% solution of 9, 10-dimethyl 1, 2 -benzanthracene acetone (DMBA) to induce an infiltrated tongue cancer. Frontal sections of the tongue from each group were stained with 5'-nucleotidase (5'-Nase) and the lymphatic capillaries were examined under a light microscope.
In the control group, the lymphatic capillaries were present in all connective tissue papillae. These lymphatic capillaries arose from the lymphatic capillary network in the lamina propria mucosae. In the experimental group, the lymphatic capillaries were also present in the connective tissue underlying the tumor so that the connective tissue structure resembled papillae. Lymphatic capillaries underlying the tumor were significantly thicker in diameter than those in the control group. The 5'-Nase activity was lower in the experimental group than in the control group.
It is conceivable that an increase in diameter is necessary so that the lymphatic capillaries can absorb a large quantity of tissue fluid. Lymphatic capillaries underlying the tumor always maintained a plexus. This result suggested that the lymphatic capillary network in the connective tissue underlying the tumor was repeatedly built and destroyed as the tumor invaded the muscle layer. An inverse relationship between 5'-Nase activity and the diameter of the lymphatic capillaries was also suggested by the results of this study.
Therefore, 5'-Nase staining was very useful for observing the lymphatic capillaries in the connective tissue underlying infiltrated squamous cell carcinoma of the tongue.

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Immunohistochemical changes of epidermal growth factor receptor (EGFR) during the genesis of tongue carcinomas were studied in male SD rats administered 50ppm 4NQO p.o. for 12 weeks. Paraffin sections were examined with immunohistochemical meth ods using monoclonal anti-EGFR antibody (clone F4), polyclonal anti-EGF antibody, polyclonal anti-TGFα antibody, monoclonal anti-keratin antibody (clone KL1), and monoclonal anti-PCNA antibody (clone PC10) by the ABC method. Immunoblotting for EGFR and keratin was evaluated at 170 k Da and 56 k Da bands. EGFR was expressed in the cell membrane of both non-tumorous epithelial cells and carcinoma cells, and EGFR staining was mostly distributed in the spinous cells of the normal epithelium and its hyperkeratotic or dysplastic counterpart. The staining level of the basal cells was much weaker. In the hyperkeratotic epithelium, the intensity of the staining was stronger than that in the normal epithelium. In carcinoma, EGFR expression was found in the highly differentiated areas of the surrounding cancer pearl, but there was no expression in peripheral tumor calls corresponding to basal cells. Keratin (KL1) reaction was noted in keratinocyte and keratinizing tumor cells, and KL1 positive cells were irregularly distributed in line with keratinization. Such irregular expression of higher molecular weight keratin occured parallel to individual cell keratinization or dysplasia. PCNA positive nuclei were confined to the basal cells and proliferating tumor cells. Immunostaining of EGF and TGFα was limited to the cytoplasm of the spinous cells in normal epithelium and induced carcinoma.
These results suggested the following:
1) In the rat tongue carcinoma induced by 4NQO, EGFR may react by autocrine mechanism of EGF/TGFα during carcinogenesis.
2) Abnormal EGFR expression in carcinoma cells may be involved in malignant transformation.
3) EGF/TGFα-EGFR interaction may be involved in processes after cell division or proliferationboth in the normal epithelium and in squamous cell carcinoma.
4) EGF/TGFα-EGFR interaction may play a part in the control of keratin production in epithelial cells under a physiological environment, and EGFR may be more intimately involved in squamous cell differentiation rather than in cell proliferation in squamous cell epithelium and squamous cell carcinoma.

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Immunohistochemical studies on the role of nm23 gene product (nucleoside diphosphate kinase: NDPK) in squamous cell carcinomas of the oral cavity were performed with clinical and histopathological factors. There was no relationship between tumor extent, differentiation, or mode of invasion and the stainability of NDPK. The NDPK-positive group tended to have a lower frequency of neck metastasis, and a better course than the NDPK-negative group.
Consequently, nm23/NDPK was suggested to be a metastasis-suppressor factor that may be useful for predicting tumor metastasis and prognosis in oral squamous cell carcinoma.

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Four cases of intraosseous squamous cell carcinoma (IOSCC) of the maxilla were identified among the 303 patients with malignant tumors who visited our clinic since February 1979. IOSCC was defined by the following criteria: 1) The tumor tissue is histologically assessed to be squamous cell carcinoma. 2) No ulcer derived from the tumor tissue is observed in the oral, nasal, or sinus mucous membranes. 3) Three-dimensional CT or MRI examination indicates that the tumor exists in the maxillary bone. 4) It is histologically confirmed that the basal layer of the covering epithelium is intact and that the main site of the tumor tissue is in the bone. IOSCC tended to metastasize to the cervical lymph nodes in contrast to squamous cell carcinomas of the maxillary sinus.

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Pleomorphic adenoma is a common neoplasm of the salivary glands. It occurs frequently in the parotid gland in the major salivary glands and in the palate in the minor salivary glands. We have treated six cases of pleomorphic adenoma of the upper lip (four females and two males, 10 to 40 years old). The locations of the 6 tumors were 4 on the right side and 2 medial. Although the most effective surgical procedure for this tumor to forestall recurrence while preserving cosmetic form is still under debate, our treatment appears to be satisfactory on both counts. We discussed these problems with referece to our results and the literature. No recurrence has occurred in any of the six patients (max. 13 years 10 months, min. 6 years; as of July, 1994). Enucleation can be used when the tumor is a pleomorphic adenoma, measures under 30 mm in diameter and shows no infiltration.

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Chronic mandibular osteomyelitis (CMO) is an inflammatory disease that is resistant to treatment. This paper describes 16 cases of CMO that were treated in our hospital between 1986 and 1992. The discussion includes various methods of treatment. An insufficient inferior alveolar artery (IAA) blood supply as determined by angiography also played a role in CMO. In the above cases, CMO was caused by several different dental diseases.
1. Ten cases were diagnosed histopathologically as supprative osteomyelitis; the remaining 6 cases were determined to be sclerosing osteomyelitis. Female patients in their fourth decade accounted for the biggest subgroup. The most frequent tooth involved was the mandibular molar.
2. Patients with supprative osteomyelitis showed characteristic symptoms: a) short duration of disease, b) local infection, c) pus discharge, and d) fistula formation. Sequestrectomy was most frequently used as a corrective procedure. Decortication combined with sequestrectomy was used in all cases with sclerotic changes of bone cortex.
3. Sclerosing osteomyelitis was clinically characterized by a long duration of disease, diffuse sclerotic changes on X-ray, and associated trismus. Among 4 cases of sclerosing osteomyelitis that underwent angiography of the IAA, 3 cases showed deformities. Therefore, angiography seemed to be a useful procedure to forecast the prognosis because it evaluates the blood supply into the mandible. Consequently, a decreased blood supply might indicate a poor response to antibiotic therapy. In cases without IAA deformity, decorticotomy alone was sufficient for treatment. On the other hand, in the cases of IAA deformity, treatment included a combination of intra-arterial antibiotic infusion and decorticotomy or saucerization.
The above procedures resulted in cure in all but 1 case of CMO.

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Thirty-eight cases of ranula are reported. Approximately half of the patients were in the second and third decades, and the male to female ratio was 1: 3. Thirty three cases were of the sublingual type. The initial treatment, which consisted of marsupialization in most cases, resulted in recurrence in approximately 30% of the patients. Extirpation of the sublingual gland was recommended in patients with multiple recurrence or with extension to the submandibular region.

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Primary malignant hemangioendothelioma is extremely rare in the oral cavity. We encountered and treated a case of malignant hemangioendothelioma of the tongue. The patient was a 46-year-old man. He visited our department with the chief complaint of painless swelling of the right side of the tongue. The lesion appeared as a localized mass covered with normal mucosa. The size of the lesion was 27 × 24 × 6 mm. A hemangioma was suspected based on MRI, CT scan, angiography and RI angiography.
The tumor was surgically enucleated under general anesthesia. Histopathologic study revealed it to be a malignant hemangioendothelioma. The patient underwent partial resection of the right side of the tongue as secondary treatment 25 days postoperatively.
Local recurrence, cervical metastasis, and distant metastasis have not been detected and progress is good 2 years 4 months after reoperation.

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We report a patient of 62-year-old woman who survived for a prolonged period after excision of a solitary intestinal malignant melanoma, diagnosed on ⁶⁷Ga-scintigraphy, following the excision of a malignant melanoma of the left maxilla.
This case suggested that ⁶⁷Ga-scintigraphy was a useful procedure for the examination of metastatic site after primary surgery.

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An extremely rare case of a gallbladder adenocarcinoma that metastasized to the mandibular bone in a 61-year-old woman is presented. The patient was referred to our department with a complaint of hypoesthesia of the right lower lip and submental region. Her medical history revealed that she had undergone resection of the gallbladder, the hilar bile duct and partially the stomach with lymph node dissection 8 months previously. Radiographs and CT scan revealed a diffuse radiolucent area with bone destruction in the right molar region of the mandible. A biopsy showed features similar to a tubular adenocarcinoma of the gallbladder. Accordingly, the lesion of the mandible was diagnosed to be a gallbladder adenocarcinoma that metastatized to the mandible.

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An extensive papilloma in the region of the alveolar ridge of the right maxilla, palate and buccal mucosa is described. A 95-year-old woman was referred to our clinic for a swelling in the maxilla. Both physical and radiographic findings mimicked a carcinoma, but the histopathologic diagnosis was a papilloma. The tumor disappeared after chemotherapy. So far, her clinical progress has been satisfactory for 2 years and 7 months.

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Osteoma of the jaw is a benign and slowly growing tumor which consists of cancellous or compact bone. This tumor is often asymptomatic unless it has grown to a certain degree. Enlarged osteomas can cause facial asymmetry or functional impairment.
In this report, a giant peripheral osteoma arising in the right mandible of a-67-year-old woman is presented. The lesion disturbed swallowing for about one year. Physical examination disclosed ari elastic-firm and nontender mass from the submental region to the right submandibular region, which caused minor facial asymmetry. Computed tomography revealed a hen egg-sized and well-circumscribed radiopaque mass with a bony density, arising from the inner surface of the right mandible. The mass was excised under general anesthesia. The resected material, 51 × 38 × 41mm in size, showed a bone-like appearance with a smooth and rough surface. Microscopically, the tumor was composed of relatively dense, compact bone with sparse marrow tissue. The histopathological diagnosis was a compact osteoma.

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Cemento-ossifying fibroma is a relatively rare osteogenic tumor of the jaw bones. A case of cemento-ossifying fibroma accompanied by a cystic area is reported here. The tumor was found in the mandibular molar region of a 52-year-old woman.
Histopathological examination showed that the tumor consisted of fibrous tissue, and contained cementicle-like tissue, woven and lamellar bone, and osteoid tissue. The fibrous tissue was perforated by multiple cystic spaces of varying size, occasionally filled with blood.
Therefore, the tumor was histopathologically diagnosed as cemento-ossifying fibroma. The cystic changes of this lesion were also discussed.

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A 48-year-old woman complained of a swelling in the lower lip. It measured 10 × 15mm and had a sharp border and elastic hardness. A white-yellow solid tumor was removed under local anesthesia.
Histopathological examination revealed compact gathering of spindle-shaped smooth muscles cells, partially covered with a fibrous capsule. The cells were stained yellow with elastica-van Gieson stain and red with Mallory-Azan stain.
The lesion was diagnosed to be a nonvascular leiomyoma. A discussion on the differential diagnosis of nonvascular and vascular leiomyomas is also provided.

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This paper presents two cases of sialolithiasis in the minor salivary glands. One occurred in the lower lip of a 75-year-old man, and the other in the buccal mucosa of a 30-year-old woman. The clinical diagnosis of both cases was a salivary gland tumor. Histologically, small salivary calculi existed in the dilated duct in association with squamous cell metaplasia, and remarkable inflammatory cell infiltration was found in the surrounding tissue of the duct. The calculi seemed to consist of an organic compound containing much sulfur, and they appeared to be immature due to the presence of decalcifying material. The incidence of minor salivary sialolithiasis among all cases of sialolithiasis over the last five years in our clinic was 2.7%.

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Blue nevus is one type of pigmented nevi and cases of the oral mucosa have rarely been reported.
The case presented is a Japanese 9-year-old boy. He had been conscious of a painless pigmented lesion on the left palatal mucosa, but had left it untreated for about 4 years as it showed no evident growth, until he was referred to our hospital. The lesion was associated with neither elevation nor ulcer formation and radiographic examination showed no bone resorption.
We performed an excisional biopsy under local anesthesia and histopathological examination revealed a massive and irregular bundle-like arrangement of spindle-shaped melanocytes including abundant melanin granules. The lesion was diagnosed to be a blue nevus.
Postoperatively, there has been no evidence of recurrence for 5 months.

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A newly devised mouth-opening exerciser is presented. It is made of a 5-mm thick acrylic resin plate and is wedge-shaped with a cut tip. The exerciser has 3-mm long stairs so that patients can notice improvement in mouth-opening during exercise. Every stair has an extremely gentle slope so that it permits gradual mouth opening without severe pain. This exerciser was very effective for postoperative mouth opening exercises in patients with severe trismus due to temporomandibular joint ankylosis and fibrosis after maxillectomy.

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