Previous studies have demonstrated that microvilli develop in malignant tumor cells and that some tumor-related antigens might be located in microvilli. Transferrin receptor (TfR) is expressed in proliferating cells and may be a tumor marker.
We studied the localization of TfR and the morphological characteristics of human epithelial carcinoma cell lines (HeLa cells, KB cells, HSC-7), HeLa cells transplanted to nude mice, and human oral squamous cell carcinoma by electron microscopic technique.
In vitro, the number of microvilli in subconfluent condition was significantly greater than that in confluent condition. TfR was found to be located in the entire plasma membrane and in microvilli by immunoelectron microscopic technique. In vivo, TfR was predominantly present along the plasma membrane and microvilli of tumor cells. These results indicate that the proliferative ability of tumor cells might correlate with the number of microvilli.

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Forty-one oral squamous cell carcinomas were immunohistochemically examined for p53 protein and PCNA. Twenty-six cases (63.4%) showed p53 overexpression, but the frequency of p53 protein was not correlated with the degree of histological differentiation.
PCNA LI was inversely correlated with the grade of histological differentiation. There was no significant difference in PCNA LI between the p53-positive group and the p53-negative group. In p53-positive cases, p53 protein and PCNA showed similar staining patterns. These results indicated that the degree of histological differentiation is associated with proliferative potential, but not with the presence of p53 protein.

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We transplanted VX 2 carcinoma into the tongue of domestic rabbits and investigated metastasis to the regional lymph nodes.
The results were as follows:
1. The rate of metastasis to the regional lymph nodes was 36.5%(35/96 lymph nodes) and was positively correlated with the growth of the transplanted VX 2 carcinoma. In Grade III, the rate of lymph node metasrasis was as high as 64.0%(16/25 lymph nodes).
2. The rate of lymph node metastasis on the side receiving the transplant was 44.9%(22/49 lymph nodes). Metastasis to the submandibular lymph nodes was 35.5%(11/31 lymph nodes), and that to the cervical lymph nodes was 61.1%(11/18 lymph nodes). The rate of lymph node metastasis on the non-transplanted side was 27.7%(13/47 lymph nodes). Metastasis to the submandibular lymph nodes was 21.4%(6/28 lymph nodes), and that to the cervical lymph node was 36.8%(7/19 lymph nodes).
3. According to the stages of lymph node metastasis by Honma's classification (1982), Stage I was 48.6%(17/35 lymph nodes), Stage II 22.9%(8/35 lymph nodes), and Stage III 28.6%(10/35 lymph nodes). On the non-transplanted side, lymph node metastasis was seen relatively early.
4. Infiltration, growth, and lymph node metastasis of the transplanted VX 2 tongue carcinoma were similar to those of human tongue cancers, indicating this to be a useful model for the study of oral cancers.

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To clarify both the mechanism of parapharyngeal involvement of head and neck cancers and the clinical usefulness of parapharyngeal dissection, the routes of lymphatic flow from the oral cavity and oropharynx to the parapharyngeal space were studied using activated carbon particles CH40.
The following results were obtained:
1. Lymphatic flow from the posterior portion of the oral cavity and that from the oropharynx reach the parapharyngeal space through lymphatic channels in the submucosa.
2. Among 6 routes of direct parapharyngeal spread of head and neck cancers, the anteromedial inferior, anteromedial superior, medial central, and anterolateral routes were found to have direction-specific routes of lymphatic flow. The flow of the former 3 routes is high, and that of the later route is low. These routes of lymphatic flow were considered to be responsible for the frequent spread of cancers into the parapharyngeal space by direct extension.
3. Lymphatic flow to the parapharyngeal space drains not only into the node of Kuttner but also into the parapharyngeal and retropharyngeal nodes through lymphatic vessels in the parapharyngeal space.
4. Anatomically, these findings suggest that parapharyngeal dissection is very useful in the management of cancers that involve the parapharyngeal space.

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Seven cases of oral leukoplakia that developed into squamous cell carcinoma during the past 14 years from January 1978 through December 1991 were studied clinicopathologically. These cases included 2 males and 5 females, and malignant transformation occurred within a mean period of 2.1 years. According to the clinical classification of Bánóczy, these leukoplakias were divided into 2 cases of simplex type, 2 cases of verrucosa type, and 3 cases of erosiva type. Histopathologically, 3 cases had mild epithelial dysplasia and 4 cases non-epithelial dysplasia. These cases were treated by cryosurgery, vaporization by CO₂ laser, excision, or by removal of the stimulus. Malignant transformation was more frequent in the cases treated by cryosurgery than in those treated by other treatment methods.

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The purpose of this study was to determine if bone morphogenetic protein (BMP) can adequately bridge alveolar clefts. Alveolar clefts were surgically created in aduly dogs. After healing, they were implanted with atelocollagen or BMP. Bone bridge formation was evaluated radiographically at 1, 2, 3, 6, 9, and 12 months. At 12 months, dogs were killed, and the specimens were examined histologically. The atelocollagen-implant cleft appeared radiolucent, with minimal new bone formation along the cleft margins, and bone bridges were not formed. The BMP-implant specimens showed almost complete filling of the clefts with bone as early as 1 month after implantation. Bone bridge formation at the clefts was completed within 3 months. The bone bridge remained stable for up to 12 months, and there was no evidence of bone resorption. The bone bridge was composed of well-mineralized lamellar bone identical to the surrounding alveolar bone. There results provide evidence that BMP can induce rapid and stable bone bridge formation in the alveolar clefts of adult dogs. The bone bridge can be expected to accomodate passive tooth eruption or orthodontic tooth movement.

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A postoperative follow-up study of internal derangement with persistent closed lock after arthroscopic surgery of the temporomandibular joint was performed in 9 patients, 11 joints.
Using a triangulation technique via a second puncture, diagnostic arthroscopy was performed, followed by arthroscopic lysis and lavage operation of the temporomandibular joint to increase mobility of condyle-disk complex. This was accomplished by using power instrumentation (Microdebrider-Small Joint Microelectric Arthroplasty System) in conjunction with an irrigation system.
We evaluated the efficiency of this instrument and irrigation system for temporomandibular joint arthroscopic surgery.
According to the criteria of the American Society of Oral and Maxillofacial Surgery and those of Takahashi and Shibata, the surgical success rate was 88.9%. Postoperatively, there was no complication or severe discomfort.

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Using the Satoh-Heimdahl method, we inoculaed Streptococcus milleri NCTC 7331 and Bacteroides fragilis NCTC 9343 into the mandibles of NZW rabbits to prepare a model of infection. We compared the tissue penetration of clarithromycin (CAM), a newly developed macrolide antibiotic, after oral administration in this animal model and in normal rabbits, which served as control. Concentrations of CAM in oral-cavity fluids and sites, including serum, tongue, gingiva, submandibular gland, parotid gland, submandibular lymph node, mandible, maxilla, and pus, were determined by bioassay.(¹⁴C) CAM (20mg/kg) was administered into the auricular veins of infected and normal animals. Macroautoradiograms were taken 5 minutes after the intravenous injection of CAM. The following results ware obtained:
1) In the infected group, peak serum levels of CAM (0.32μg/ml) were obtained 0.75 hour after oral adminstration. Peak tissue levels of CAM (0.68-2.39μg/g) were attained 0.5-1 hour after treatment. The ratio of the peak oral tissue level to the peak serum level ranged from 2.31 to 7.47. One hour after treatment, the peak level of CAM in pus (0.1μg/ml) was obtained, and the ratio of the peak pus: serum level was 0.31.
2) In the normal group, peak serum levels of CAM (0.16μg/ml) were obtained 0.5 hour after treatment. Peak tissue levels of CAM (0.19-1.05μg/g) were obtained 0.5-2 hours after treatment. The ratio of the peak oral tissue level to the peak serum level ranged from 1.19 to 6.56.
3) In the infected group, macroautoradiograms disclosed an area with comparatively high radioactivity exceeding the blood CAM level, particularly around the focus of infection.
4) The results of bioassay showed, high radioactivity primarily in submandibular gland tissue and in the submandibular lymph nodes in both the infected group and the normal group.
In general, the tissue levels of macrolides are higher than their blood levels. The results of the present experiment with CAM are consistent with this finding. High concentration of CAM were selectively distributed around sites of infection in the jaw bones; CAM can therefore exert its inherent antibiotic effect.

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“Intraoral actinomycosis” is considered to be a rare disease. Eight cases of intraoral actinomycosis diagnosed histopathologically are reported. Four cases occurred at the periapical region and the other four occurred at the submucosal region. Sulphur granules were clinically found in the pus or granulation tissue. Associated lesions were pericoronitis, radicular cysts, marginal periodontitis, and sequestra. Infected material and causative factors were surgically removed from the site. Long-term antibiotic therapy was not required in any patient.

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Salivary gland tumors clinically showing a cystic pattern are relatively rare in the oral and maxillofacial region. Mucoepidermoid carcinoma rarely shows a cystic pattern clinically and is rarely found in the jaw.
A 23-year-old woman with central mucoepidermoid carcinoma in the maxilla is presented. She complained of swelling of the right side of the palate, present for the last 5 years. X-ray examination revealed two adjacent, cystic lesions: one small egg-sized lesion located in the 6 5 4 region, and partly in the maxillary sinus, and one thumb-tip-sized lesion located in the other right maxillary retromolar region. The clinical diagnosis was a maxillary cyst of the 6 5 4 region and an odontogenic cyst of the 8 region. The two cystic lesions were removed orally. The legions were pathologically diagnosed as a primordial cyst and mucoepidermoid carcinoma. Partial maxillectomy, including 4 toward the retromolar area, was performed just after diagnosis of mucoepidermoid carcinoma. She was alive, without local recurrence or metastasis, as of 3 years after a 2nd operation.

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We report a case of aspergillosis of the maxillary sinus in a 58-year-old woman with carcinomatous pleuritis suspected to be associated with metastasis of mammary cancer. Since surgical therapy for aspergillosis was precluded by the patient's general condition, we attempted long-term therapy with fluconazole. This treatment was effective, with no side effects, for aspergillosis for 13 months, after which she died of carcinomatous pleuritis.

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Marignant hemangiosarcoma is relativcly rare in the oral cavity. Here we describe a case of malignant hemangiosarcoma of the tongue suspected to be a benign tumor.
Our case was a woman 72 years of age who noticed the lesion several weeks previously as a bean-sized swelling on her tongue. The tumor was dark red and measured 8×5×5mm. The surface was smooth and elastic hard. It was tender, but not pulsating. As the tumor was partially necrotic, it was resected, with a surgical margin of 5mm. The pathological diagnosis of the specimen was malignant hemangiosarcoma. Whole-body scintigraphy and CT scan showed no abnormalities.
At present, 2 years and 2 months after operation, there is no evidence of local recurrence or distant metastasis.

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Upper lip cancer is extremely rare in Japanese patients. We report a case of squamous cell carcinoma of the upper lip mucosa in a patient in whom a bilateral perialar crescentic advancement (PCA) flap and an Abbe flap were used for immediate reconstruction. The patient, a 39-year-old man, presented with a tumor (dimensions, 25×21mm) on the upper lip mucosa. A full-thickness defect caused by surgical excision of the tumor extended over two-thirds of the upper lip. To reconstruct the large defect of the lip, a bilateral PCA flap and an Abbe flap were utilized. Two weeks after the operation, the pedicle of the Abbe flap was divided and returned to the lower lip. One month after the second operation, elongation of the oral fissure and restoration of the angle of the mouth were performed. Combined use of a bilateral PCA flap and an Abbe flap for reconstruction of the large defect of the upper lip has resulted in an excellent cosmetic and functional outcome to surgery, with no clinical evidence of recurrence.

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Malignant lymphoma occurs frequently in the head and neck region, but rarely in the mandible. Here we report a case of non-Hodgkin's malignant lymphoma arising from the middle of the mandible. The patient was a 68-year-old man, and histopathological examination indicated malignant lymphoma of diffuse large cell type. Further examination using immunohistochemical methods disclosed B-cell nature. The patient received chemotherapy and radiotherapy, and has been under observation for 7 months without recurrence.

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A rare case of acute myelocytic leukemia which relapsed in association with tumor formation is presented. A-36-year-old man was referred to our department for gingival swelling at the left side of the mandible. Although a complete remission of acute myelocytic leukemia was achieved hematologically, examination of a biopsy speciman revealed infiltration of leukemic cells. The patient died about six months after presentation, despite chemotherapy and radiotherapy.

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We report a case of synovial osteochondoromatosis localized in the upper joint compartment of the right side of the TMJ. A calcified nodular lesion was detected on arthrography CT, and MRI.
The lesion was extirpated by arthroscopic surgery.

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A case of canalicular adenoma of the maxillary gingivolabial fold in a Japanese 47-year-old woman is reported. The tumor was approximately 10 mm in diameter, elastic soft, freely movable, and painless. It was excised under local anesthesia.
Histologically, the tumor was entirely encapsulated. Small ducts were formed, chiefly by bilayered, columnar epithelial tumor cells. The stroma was loose and relatively highly vascular. Canalicular adenoma was the histopathological diagnosis according to the revised WHO classification (1991).
The postoperative course was satisfactory. The clinicopathological findings of this tumor were discussed briefly, referring to the literature.

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We report a rare case of distal arthrogryposis syndrome associated with a tongue anomaly. A 3-year-old girl visited us complaining of articulation and aesthetic disorders, caused by a tongue anomaly and a tongue habit. At birth, she had flexion contracture of both fingers, equinus deformity of both feet, slight abduction disturbance of the right hip joint and a tongue anomaly, in which the tongue was shaped like a cylinder. There were five similar cases of tongue anomaly within her family, whereas no other case had bone or joint disorders. The diagnosis of this case was distal arthrogryposis syndrome type II. The width of the maxillary dentition was decreased. The length of the maxillary and mandibular dentition was increased. The patient had an articulation disorder, evaluated as fricative alveolar/s, z/, but she articulated single sounds almost clearly. She had no difficulty in everyday conversation. To manage her tongue habit, she uses a tongue-guard while asleep.

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Definitive diagnosis of amyloidosis is very difficult clinically, because this disease is extremely rare and associated with various symptoms. We encountered and treated a patient with a mass of the tongue who was found to have systemic amyloidosis.
A 51-year-old man was referred to our department with a complaint of painless swelling of the center of dorsum of the tongue. The lesion measured 18×15×3mm and was located in front of the sulcus terminalis of the tongue. It had a sharp border and elastic hardness. Examination of a blood sample revealed nothing paticular. Median rhomboid glositis was suspected clinically, but a tumorous lesion could not be ruled out. A biopsy was performed, and the histopathological diagnosis was amyloidosis of the tongue. We suspected systemic amyloidosis and requested the department of neurology at our university to perform further examinations. Amyloid deposition was found in a biopsy specimen taken from the large intestine, and a diagnosis of systemic amyloidosis was made. The amyloid deposition of the tongue was surgically resected, and there have been no remarkable changes as of 6 months after treatment.

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Chronic sclerosing sialoadenitis arises often in the submandibular gland and rarely in the sublingual gland. We report a case of this disease arising in the sublingual gland.
A 52-year-old man was referred to our clinic for a painless swelling in left sublingual region. On clinical examination, there was swelling (35×15mm) and induration (21×11mm) in the left sublingual region. On radiographic examination, no abnormal finding, such as a sialolith, was noted in this area. The diagnosis was a tumor or chronic sialoadenitis. An incisional biopsy was performed for histologic examination. The lesion was diagnosed as sclerosing sublingual sialoadenitis. During the follow-up period, the swelling and induration of the sublingual gland region gradually decreased and were no longer evident 7 months after the biopsy.

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We present a case of a relatively large epulis osteoplastica (epulis osteomatosa), suspected of being a malignant tumor on initial examination, in the mandibular molar region.
The patient was a 26-year-old man with a painless mass in his left mandibular gingiva. He had first noticed the mass more than 10 years previously. On initial examination, an eggsized mass was found in the left lower molar region, and x-ray examination revealed calcification in the form of a radiopaque shadow. Various examinations, including biopsy, revealed no evidence of malignancy, and the mass was resected under general anesthesia. The lesion measured 65×50×45mm. Histopathologic examination revealed fairly calcified, chondroid tissue and irregular bone tissue in the mass, and lamination was found at its base. On the basis of these three findings, a diagnosis of epulis osteoplastica (epulis osteomatosa) was made.

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Hyperplasia of the minor salivary glands is an idiopathic rare lesion;most lesions arise on the palate and appear as an asymptomatic localized tumor, which is difficult to differentiate from other tumorous lesions.Histpathologically this lesion has normal salivary glands, with no signs of inflammation.
In this paper, a case of hyperplasia of the minor salivary gland (palatine gland), located on the soft palate in a 46-year-old man, is reported.

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