Eight cases of adenoid cystic carcinoma were studied clinico-pathologically and immunohistochemically. The eight cases were classified into three histological grades according to Philip's grading system. Localizations of PCNA, p 53, and EGF were examined by using an immunohistochemical staining method. The results were as follows:
1. Neural invasion was found in 2/3 of the Grade III cases and Vascular permeation was found in all of the Grade III cases.
2. The expression or p 53 protein was detected in only one of the Grade III cases.
3. The PCNA-positive rates in Grade III cases were higher than in Grades III and II.
4. The expression of EGF antigen was not detected in eight cases of adenoid cystic ca rcinoma.

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In this study, 22 informed oral cancer patients who were treated between 1985 and 1996 at First Department of Oral and Maxillofacial Surgery, Kyushu Dental College Hospital were analyzed by questionnaire about informing cancer. The results are summarized as follows:
(1) Fifteen patients (68.2 %) wanted to know their true diagnosis. On the other hand, 3 patients (13.6 %) did not want to know, but two of the three patients answered that the telling the true diagnosis was good.
(2) All patients hoped to know the true diagnosis prior to surgery, and 11 patients (50 %) hoped to know that at the time of revealing the pathological diagnosis. Twenty patients (90.9 %) hoped to be told the true diagnosis by the doctor.
(3) Though informing cancer induces fear, it was shown by the questionnaire that informing cancer was effective for cancer treatment.
(4) Eleven patients (50 %) answered that they would inform their families of the diagnosis of cancer.
It was suggested that telling the true diagnosis of oral cancer to patients is good.

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The postoperative speech function was assessed with a speech intelligibility test of 100 Japanese monosyllables. The subject was 19 patients with surgical reconstruction after complete ablation of cancer of the floor of the mouth. Among them, the radial forearm flap (FAF) was used in 12 patients, the pectoralis major myocutaneous flap (PMMCF) and the rectus abdominis flap were performed in 3 cases each, and a combination of FAF and PMMCF was in one patient. Concerning removed tongue area, fourteen patients had partial resection of the tongue, one had removal of a half of the oral tongue, one had hemiglossectomy, and 3 had subtotal resection of the tongue. The speech function was analyzed to find out influences of operation factors, such as, size of the tumor, area of tongue resected, operation site, and methods of reconstruction. As a result, there was less relation between sizes of the primary tumor (T-classification), however, the wider the area of resected tongue, the worse the speech function. Patients of cancer of the lateral part of the mouth floor had significantly better speech scores than patients whose cancers were in the anterior part of the mouth. Then, the improvement of operative techniques as well as the prosthetic treatment were proposed to obtain better speech function.

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The Kyushu Working Group on Oral Cancer was founded in April 1994 to raise the level of clinical studies on malignsnt tumors of the oral cavity and its adjacent regions, and improve the treatment results through a multi-institutional cooperative study. The documentation sheets, which are used in all participating institutions and record data for patients with carcinoma of the lip, oral cavity, oropharynx (UICC classification), and intraosseous carcinoma of the jaw, were prepared.
The documentation sheets were composed of the following items: 1) general information about a patient, for example, age, sex, and untreated or treated condition; 2) date of diagnosis, TNM classification including pTNM and matters relation to diagnosis; 3) date of initial treatment, treatment method, and course after treatment (i.e., tumor control or recurrence) ; 4) details of surgery, radiotherapy, chemotherapy and other treatment methods for primary tumors and metastatic lesions; 5) multiple primary cancers within the same site (organ) or at a dif f f erent site (organ), and synchronous or metachronous cancers; and 6) summary of treatment methods, the observation period and the outcome of patients such as survival status or cause of death.
Our agreement on several controversial terms used in these sheets, experiences while using these sheets and additional contents, which we think should be included in future documentation sheets, were described. The obtained data can be easily put into a computer using the software corresponding to documentation sheets and they are simultaneously stored in the data base software (File Maker Pro. Ver. 3.0) .

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Osteoradionecrosis of the jaws mainly occurs in the mandible but rarely in the maxilla due to anatomical factors. This report describes a rare case of maxillary osteoradionecrosis that occurred 2 years 2 months after treatment of advanced cancer of the maxillary sinus.
Because of advanced cancer of the maxillary sinus (T3N0M0), a 74-year-old female underwent 50 Gy irradiation with intraartial infusion of 2, 500 mg 5-Fu, tumor reduction surgery, and 24 Gy intracavitary brachytherapy with high dose rate iridium from March to May in 1993. While the cancer was well controlled by these treatments, the patient was found to have abscess formation in the left inf raorbital region on June 26, 1995 and ref errend to our department on July 10, 1995.
After incision of the abscess, conservative treatment was given to the patient as an outpatient; sequestration began to occur; and the sequester (24×15mm) in the left orbital base was separated on October 17, 1995. Although the inflammation disappeared, a full-thickness skin defect (18×8mm) penetrating through the maxillary sinus in the left inf raorbital region developed. This defect was reconstructed by using the triangular hinge flap below it and the buccal local flap. The result of reconstruction was esthetically satisfactory.

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Immediate reconstruction using the anterior part of the mandibular ramus was performed for zygomaticoorbital floor defect which occurred due to total maxillectomy. In this method, the coronoid process was attached to the zygomatic body and the lateral cortical bone to the orbital floor, and all parts were fixed by titanium mini-plates and screws. The operation resulted in recovery of a desirable shape and prevention of sinking of the eyeballs. Although the indication of this technique was limited to preserving the mandibular ramus, it was useful for zygomaticoorbital defect.

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