p34^cdc2 protein directly regulating the cell cycle in 63 patients suffering from tongue squamous cell carcinomas (SCCs) was investigated by the immunohistochemical method. p34^cdc2 was detected in 34 of 63 tumors (54.0%) using a staining method. The average incidence of p34^cdc2 positive cells was 17.7%. A distributive tendency of p34^cdc2 protein, which was expressed in the periphery of the cancer cell nest and scattered over the diffuse infiltrating cancer, was found.
The research on the relation between the expression of p34^cdc2 and the factor T suggested that positive staining of p34^cdc2 was shown in 4 of 11 cases (36.4%) of T1 tumor, 22 of 37 cases (59.5%) of T2 tumor, and 4 of 5 cases (80.0%) of T3 tumor, and showed an increasing tendency of p34^cdc2 incidence from T1 tumor to T3 tumor, but showed a low incidence in 4 of 10 cases (40.0%) of T4 tumor. The investigation on the relation between the expression of p34^cdc2 and factor N showed that p34^cdc2 was in 14 of 32 cases (43.8%) of N0 tumor, 19 of 25 cases (76.0%) of N1 tumor and 1 of 6 cases (16.7%) of N2 tumor, which was fewer. The survey of the relation between the expression of p34^cdc2 and tumor stage also showed an increasing expression of p34^cdc2 corresponding with the increasing stage of the tumor from stage I to stage III, but a decreased expression of p34^cdc2 appeared in stage IV. Namely, it suggested that the cell proliferating activity increased corresponding with the clinical progression of the tumor, however, the activity decreased in the most advanced tumor. The observation of the relation between the expression of p34^cdc2 and histopathologic findings showed that higher incidence of p34^cdc2 was found in 5 of 5 cases (100%) in WHO Grade III tumor, 10 of 15 cases (66.7%) in 4C and 4D invasive tumor, 13 of 17 cases (76.5%) in severe cellular atypia tumor. Namely, there was a correlation between the expression of p34^cdc2 and the histologic malignancy of tumor.
The results suggested that the detection of p34^cdc2 expression was beneficial for elucidating the nature of tumor malignancy of tongue squamous cell carcinoma.

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This paper describes an evaluation of swallowing using videofluorography in oral cancer patients. Seventeen oral cancer patients with surgical treatment were examined. The swallowing data of these patients were detected and recorded with videofluorography images preoperatively and postoperatively when transoral feeding was started. The videofluorography images are valuable to detect abnormal swallowing that cannot be detected by clinical observation. Our medical staff and the patients watched videofluorography records together, and discussed swallowing therapy. As a result, the patients were interested in the swallowing therapy. It is important to evaluate the swallowing reflex with videofluorography images in order to acquire patient's understanding of swallowing therapy.

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Twenty-six patients with stage I tongue cancer, who underwent excisional biopsy in our clinic between April, 1980 and December 1995, were retrospectively analyzed, focusing on the relationship between pathological findings and secondary neck metastasis (SNM) . Results obtained were as follows.
1. SNM developed in 26.9 % of 26 the cases and was found within 5-15 months after surgery. Two cases metastasized to level I, 2 cases to level II, and 3 cases to levels I & II. The number of metastasized lymph nodes was 1-5.
2. As the pathological tumor size (pT) became larger, tumor cells invaded deeper, revealing that pT in cases that invaded into the muscular layer was 13.1±2.8 mm, which was statistically significant at p<0.01 in comparison with other cases.
3. SNM developed in 20 % of 5 cases that invaded on the border of the muscular layer, and in 40 % of 15 cases that invaded into the muscular layer. However, there was no correlation between pT and SNM.
4. In regard to grading by WHO, SNM was found in 27.8 % of patients in Grade I, in 16.7 % of those in Grade II, and in 50.0 % of those in Grade III.
5. As to mode of invasion by Yamamoto, et al., no SNM developed in patients who belonged to mode 1 and 2. In mode 3 patients, however, 20.0 % developed SNM, as did 71.4 % of patients in mode 4C.
6. There was no correlation between lymphatic invasion in the resected specimens and SNM.
7. Because 7 cases that developed SNM revealed extranodular invasion pathologically, all but two cases underwent irradiation (22-54Gy), and three of them furthermore underwent chemotherapy.
8. The 5-year cumulative survival rate in this series was 71.1 %.
9. We feel that elective neck dissection should be done in cases that measure more than 10 mm in pT, that invade into the muscular layer, and belong to mode 4C (and/or 4D), even though they may be stage I tongue cancers.

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To clarify the incidence, pattern, and risk factors of neck metastasis in squamous cell carcinoma (SCC) of the maxillary gum, 22 patients with squamous cell carcinoma of the upper gum were reviewed clinicopathologically.
Among the 22 patients, 4 (18.2%) had primary neck metastasis and 7 (31.8%) had developed neck metastasis secondarily; thus the incidence of neck metastasis in SCC of the upper gum was 50.0%. Additionally, 3 out of 11 patients with neck metastasis had contralateral neck involvement. A high prevalence of neck metastasis was found in T4, endophytic, and posteriorly-located tumors, and the level II node was the most highly involved. All of these patients' neck metastases were controlled by neck dissection; how ever, metastasis in the lung is the major cause of mortality in SCC of the upper gum. Thus, the 5-year cumulative survival rate was 79.1 % in the 22 patients who received radical treatment.

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Polymorphous low-grade adenocarcinoma (PLGA) is a malignant tumor of minor salivary glands, most frequently seen on the palate. It is characterized by cytologic uniformity and histologic blandness, with variable, infiltrating growth patterns. The authors report here three caces of PLGA. The tumors were found on the right inferior surface of the tongue in case 1, and on the palate in cases 2 and 3. In case 1, partial glossectomy with supraomohyoid neck dissection was performed, because of submandibular lymphnode metastasis, and partial resection of the palate was done in cases 2 and 3. In cases 1 and 2, neither recurrence nor metastasis was recognized in follow-up observation of from 4 to 7 years. Case 3 died of old age 8 months after surgery. The histopathologic findings of the excised tumors showed various growth patterns, i.e. solid, tubular, cribrif orm, trabecular, and lobular, although tumor cells were small or medium in size, with a uniform round nucleus, and mitosis was rare. By immunohistochemical examinations, a part of tumor cells in case 1 was positive for cytokeratin and S-100 protein, while tumor cells of cases 2 and 3 were positive for not only cytokeratin and S-100 protein but also vimentin and actin. Expression of carcinoembryonic antigen and epitherial membrane antigen was not observed in the three cases.

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A case of cystic lymphangioma in the right submandibular region of a 12-year-old male, treated with local injection of OK-432 is presented. The tumor was clinically diagnosed as hemangioma at the first visit. Compression therapy was subsequently performed; the lesion showed marked shrinkage. The final diagnosis of cystic lymphangioma was based on biochemical analysis of contents aspirated from the lesion which relapsed 10 months after compression therapy. Therefore, local injection of OK-432 was performed two times (first; 0.05KE, second; 0.025KE, total; 0.075KE) . The tumor remarkably reduced in size without serious complication. There has been no evidence of recurrence for 2 years since treatment.

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