The clinical effects of intratumor injections of OK-432 given to patients with advanced oromaxillary squamous cell carcinoma were studied in 10 cases.
Furthermore, SCC antigen level and O^-₂ generation from peripheral neutrophils were evaluated according to clinical courses after the injections. The results were as follows: Four cases were effective, but six cases were shown ineffective. Intratumor injection of OK-432 with high dose, accompained by irradiation and salvage therapy, was proven very effective in a stage III case of maxillary sinus cancer. The tumor mass disappeared rapidly and the patient has been in remission for seven years and five months. However, local injections given to progressive cases with remote and/or regional lymphnode's metastases were not as effective. The cases with severe cachexy didn't show any beneficial reaction to OK-432.O^-₂ generation from peripheral neutrophils was suppressed and showed no increasing tendencies in these cases. The side effects from a large quantity of intratumor injections caused elevated fevers (38-40°C) and chills in all patients, loss of appetite in eight, fatigue in two, headache in one, and a reversible mental disorder in one case, also.

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Interleukin-2 (IL-2) was administrated to three cases of progressive oral cancer, and the immunological activities were observed.
Case 1: A 77 year-old man with recurrent squamous cell carcinoma of the buccal mucosa.2.59×10⁷JRU (Japan Reference Unit) of IL-2 was injected into the tissue surrounding the tumor for 24 days. The regression of the tumor was observed, and was considered to the partial response (PR) . However, the tumor made progeress and the patient passed away after 4 years.
Case 2: A 62 year-old woman with progressed squamous cell carcinoma of buccal mucosa. 7.7×10⁶JRU of IL-2 was injected intravenously for 11 days. The tumor made progress despite the radiation and chemotherapies, the patient underwent and she passed away after 2 months.
Case 3: A 63 year-old man with squamous cell carcinoma of maxillary sinus. After 3 weeks of partial resection of the maxilla the residual tumor was observed on the pterigoid fossa. 1.5×10⁷JRU of IL-2 was administrated intravenously with⁶⁰Co radiation. The patient has been living without tumor since 1988.
The number of eosinophilic leucocytes were increased in case 1, and the number of total lymphocytes were increased in cases 1 and 3. Some kinds of phenotypes of lymphocytes were in high level in case 2, however they were not increased after treatment. In cases 1 and 3, CD 57 and CD 16 positive cells were increased after the administration of IL-2, and NK and LAK activities were also increased.

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Concerning the clinical study of terminal stage patients with head and neck malignant tumors, we studied the immunological change and nutritional condition. 19 cases of death from head and neck malignant tumors were studied: 10 cases were men, 9 cases were women.
Eight cases were under control of liquid food (including tube feeding) . Nine cases were treated with IVH and tube feeding. Two cases were treated with IVH only.
We used suppositories of anti-pyretic pain killer many times to relieve the pain, and in two cases codeine phosphate was used.
Five cases were tracheotomized for the purpose of controlling the breathing and in one case, a respirator was used.
In these cases, we investigated the number of red blood cells, white blood cells and lymphocytes, and subpopulation of lymphocytes, serum SCC antigen, serum protein, serum albumin.

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The method of using the anterior margin of the mastoid process (the most inferior point of the tympanomastoid fissure) to find out the facial nerve at parotidectomy is described. This marker can be easily palpated and visualized after considerable dissection. The main trunk of the facial nerve is located 1 cm deep from this point. This marker is considered to be extremely useful, because (1) it is easy and safe to find, (2) it is constant and fixed in its position, and (3) the point leads to the stylomastoid foramen.

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We studied 18 patients with maxillofacial defects, who had undergone reconstructive surgery at our clinic from January 1985 to October 1991.
The patients included 11 male and 7 female (male/female ratio: 1, 57: 1), with the age the at first examination ranging from 25 to 82 (average: 52.8 years) .
All cases were immediately reconstructed, and 14 cases had preoperative radiotherapy or chemotherapy.
Primary diseases were squamous cell carcinoma (14), liposarcoma (1), rhabdomyosarcoma (1), malignant ameloblastoma (1), and ameloblastoma (1) .
When classified by the reconstruction sites, there were 11 cases with reconstruction of soft tissue only, 6 cases of mandible only, and 4 cases of mandible and soft tissue.
The reconstruction of soft tissue only was successfully performed by D-P flap in 4 cases, cervical island flap in one case, and forearm flap in 2 cases.
The reconstruction of mandible was successful in one case, where iliac crest was used, and in another case where vascularized osteocutaneous scapular flap was used while the reconstruction including soft tissue was successfully performed by vascularized osteocutaneous scapular flap in one case.
The reconstruction of soft tissue yields satisfactory results by both pedicle and free flaps if proper consideration is given to the reconstruction site and range, whereas the above results suggest that vascularized osteocutaneous free flap may be recommended for the reconstruction of relatively severe defects including mandible and soft tissues.

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Five cases of ameloblastoma of the mandible occurred in the children are reported. 2 cases were boys and 3 were girls. The age of the patients ranged from 10 to 14 years (average 12.6 years) . In the X-ray findings, unilocular lesions were found in 3 cases and the remaining 2 cases had multilocular cystic lesions. We treated 4 out of 5 cases, and a reduction of lesions was found clinically and radiologically after marsupialization. Thereafter minimal resection of mandible was performed satisfactorily. Histopathologial findings showed plexiform type ameloblastoma in all cases. All cases have had no recurrence of ameloblastoma.
Too large resection of mandible may be detrimental to the results of the treatment for children. It is suggested that marsupialization is effective in the treatment of cystic ameloblastoma.
Additionally, we made a review of the literature and had a clinical discussion with regards to ameloblastoma in child.

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This paper presents a clinical evaluation of the oral multiple primary cancer at the Department of Oral Surgery, Saitama Cancer Center.
From 1975 to 1991, 15 patients of oral multiple primary cancer were treated. New criteria of oral multiple cancer are suggested as follows: (1) the tumors are found in different sites which are classified by UICC, (2) in the case of the same site, the tumors exist in both the right and the left side, (3) in the case of the same side, the tumors are completely separated at least at a distance of 1.5 cm and non-neoplastic tissue is recognized between them, (4) pathologically, the tumors show the malignancy, (5) the tumor occurs over 10 years after the disappearance of the malignant tumor by radiotherapy (radiation induced cancer) .
The incidence of oral multiple primary cancer was 3.0% among 496 oral carcinomas at the Department of Oral Surgery, Saitama Cancer Center. Six out of 15 cases were male and 9 were female. The age ranged from 25 to 80 years old and their average was 58.2 years old. The tumors were seen synchronously in 4 cases and metachronously in 11 cases. The additional tumors occurred on average 3 years and 8 months after the recognition of the first tumor. The secondary lesion was generally discovered at the earlier stage as compared to that of the primary one.
The relation between drinking, smoking and carcinogenesis was not recognized.
These evaluations suggest that long-term follow-up and careful examination are necessary for getting successful outcome.

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Multiple primary tumors are increasing as a result of the increase of malignant tumors. Some cases are difficult to be distinguished from metastatic tumors.
A case of multiple primary carcinomas in the left side submandibular gland and the right side lung was reported. A 77 year-old man visited our department complaining of a painless swelling on the left side of the submandibular region. There was no swelling in the regional lymph nodes. X-ray examination revealed a tumorous lesion in the right side lung. Biopsy of the submandibular lesion was performed and histopathological diagnosis was mucoepidermoid carcinoma of submandibular gland. Biopsy of the lung tumor indicated the possibility that the tumor was metastasis from the salivary gland tumor. Under general anesthesia the tumor of submandibular gland was excised with the surrounding healthy tissues, and the submandibular region was immediately reconstructed with D-P flap and titanium plate. One month after the operation the lung tumor was excised and the D-P flap was ressected. Histopathological diagnosis of the lung tumor was poorly differentiated adenocarcinoma of the lung.
From the above this case was proved to be multiple primary carcinoma of the submandibular gland and the lung.

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Angiomyoma is a benign tumor first reported by Stout in 1937.
Angiomyoma is uncommon in the oral cavity.
A case of angiomyoma arising in the lower lip was reported, and a review of literature was carried out.
A 30-year-old man whose chief complaint was a painless mass in the left side of lower lip, was referred to our department. On the same day, removal of the tumor was carried out under local anesthesia. The histological diagnosis was angiomyoma.
There, has been 65 cases of angiomyoma in the oral cavity in the Japanese literature, including this case.

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Carotid body tumor is a rare neoplasm. In this paper we suggest that selective carotid angiogram is effective for the diagnosis of carotid body tumor.
A 43 year-old woman was referred to Oral Surgery Clinic, Saitama Cancer Center with complaint of a painless mass in the right neck on December 13, 1990.
An examination of the carotid angiogram revealed that tumor was hypervascular and located at the carotid bifurcation and nutrient artery came from external carotid artery and so the clinical diagnosis“carotid body tumor, Shamblin's type I”was obtained. The tumor was easily removed under general anesthesia.
The pathological examination showed paraganglioma. The clinical course after operation has been satisfactory.

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Ameloblastic fibroma is a rare odontogenic tumor. Generally, the tumor occurs intraosseously in youth, between 15 and 20 years.
Recently we experienced a case of ameloblastic fibroma in a one and half-year-old girl. A congenital polypoid lesion was located on mandibular alveolus corresponding to second primary molar. The tumor excision was performed with first primary molar under general anesthesia.
Pathologically, the tumor consisted of strands and groups of odontogenic epithelial cells in an immature fibrous tissue background.
The postoperative course has shown no evidence of recurrence for a year and complete erruption of second primary molar has been attained.

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Recently, multiple cancers tend to be increasing as cancer patient on average have been living longer due to the development of diagnosis for cancers, and multidisciplinary treatment for cancers.
We present a 59-year-old male with four primary cancers, which appeared in stomach, sigmoid colon, oral floor, and parotis respectively. The patient was admitted to our department because of oral floor pain in May, 1987. He was diagnosed as carcinoma of oral floor, and recieved radiation, surgery and chemotherapy. Parotid carcinoma appeared, however, 4 months after discharge from our hospital. He died of extention of the tumor in spite of the treatment at department of otorhinolaryngology of our hospital. He also received treatments of cancers, in stomach in 1980 and sigmoid colon in 1982 at another hospital.

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