1) A role of the salivary glands playing in maintaining isohydric homeostasis of the blood or body fluid was investigated by comparing the pH of human proper saliva, consecutively measured with B.T.B. pH test papers, with the levels of consciousness which were subjectively sensible as clear or drowsy. This report may also somewhat contribute to clarify the presence or significance of an excretory function taking place through the salivary glands. 2) In addition to biorhythmical circadian fluctuation of salivary pH reported previously, the change in pH of proper saliva depending upon a dominancy of each of the autonomic nerves was evidently found out by detecting continuously both salivary pH and the state of consciousness. Experimentally, the pH was as low as 6.5 or less in the time of clear consciousness, whereas it was slightly high as 6.8 or more than this value in the light drowsy state. From the viewpoint of the autonomic nervous activities it was presumed that the parasympatheticotonic condition, even when occurred either suddenly or gradually, was favorable for an elevation in pH of excreted proper saliva to a value of about 6.8. 3) An increase in pH to about 6.8, taking place with gradual or sudden patterns, distinctly signified a loss of consciousness expressible psychophysiologically by light sleep. Even sudden return of the lost consciousness to a normal state did not cause parallel immediate recovery of the pH values to previous levels. In these observations, the limit of the pH values which distinguished clear consciousness from drowsy one was 6.8. The inertia of the change in salivary pH was found to be about ten minutes. 4) Supposedly, the fluctuation of salivary pH values is not only a sequence of hypothalamic autonomic capability but a peripheral one such as a change in absorption process in the salivary glands. A part of neural mechanisms determining conscious level will control a dominancy of each of both autonomic nervous systems. When parasympatheticotony is present, the salivary pH will refer to an active excretion or a passive leakage of HCO_3^- from the blood. In detail, the content of this anion in blood might be increased either by hypothalamic control for blood electrolyte distribution or by reabsorption increase in the kidney, resulting in salivary pH elevation by the salivary glands which are hypothetically excretory in nature partially. As a result of the deviation of autonomic isohydric activities, the salivary glands, probably behaving like leaky machinery for blood electrolytes, may cause an elevation of salivary pH via the change in HCO_3^-. 5) Autonomic activity, either sympathotonic or parasympathotonic dominancy, behaves as a modulator of the circadian pH rhythm which is an expression of salivary contribution to maintenance of body fluid pH. A role, not essential but less, of the salivary glands playing as a regulator for blood pH was supposed. The supposition described here will be confirmed by animal experiments in the near future.

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A considerable number of clinical and laboratory observations have been reported to indicate that adrenocorticotrophic hormone and adrenocortical hormone inhibit the growth of granulation tissue and thereby retard the healing of wounds. The literature on the effect of adrenocortical hormone in the healing process of extraction wounds is not frequent. In addition, the report may be deemed insufficient from a thorough experimental observation point of view. The present report was undertaken to determine the healing process of extraction wounds in adult dogs by prolonged administration of adrenocortical hormone (prednisolone). The animals were divided into control and three experimental groups. The prednisolone was administered oraly once daily for some days before the extraction wound was made and thereafter until the time of sacrifice. The doses of each groups were daily 0.25mg./kg., 0.5mg./kg., and 5mg./kg. of body weight. The animals were sacrificed in groups after extraction so that wounds of the following duration could be examined : one, three, five, seven, ten, fourteen, twenty-one, thirty, forty and fifty days. The results are summarized as follows. Study of healing of extraction wounds in prednisolone-treated dogs showed retardation of the healing process since an early stage after the extraction of teeth and thereby retarded the wound healing. 1. There appeared slow re-epithelization of the extraction wounds in the treated animals. 2. There appeared to be inhibition of organization of blood clot. 3. There appeared to be inhibition of growth and maturation of granulation tissue replacement. 4. There appeared to be interference with formation and growth of new bone in the sockets throughout the experiment. 5. The healing process of extraction wounds were delayed in proportion to the amount of prednisolone administered. 6. All significant alterations observed in this study are thought to appear due to the retardation of the production of all mesenchymal cellular elements of repair.

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Four dimentional clinical studies, chiefly by hearing test of nasality, articulation, and intelligibility, were presented in order to compare and discuss the efficacy of speech aid appliance and pharyngeal flap operation. Analysis by soundspectrograph and respiratory leak value by manometer were observed as the objective evaluations of hearing test. And the muscle stimulation of speech aid appliance was investigated by radiocephalometric measurements. These studies employed 26 subjects who had been treated by speech aid appliance, and 26 subjects who had been treated by pharyngeal flap operation. 15 subjects in these were operated after the speech aid application for a period of time. The observational period was 1 week to 5 months after speech aid application, and 1 week to 3 months after pharyngeal flap operation. The long term follow up observation was made of 15 subjects for 6 to 12 months after pharyngeal flap operation. The results were as follows ; 1. The pharyngeal flap operation was more effective than speech aid appliance in comparison of hearing test, of analysis by soundspectrograph, and of respiratory leak values by manometer. Nasality and nasal emission persisted in more than half of the subjects with speech aid appliance, while in the majority of the subjects who had pharyngeal flap operation, nasality and nasal emission were eliminated in 1 week to 12 months after the operation. 2. The improvements were most remarkable in 1 week to 1 month after speech aid application or pharyngeal flap operation. Thereafter, the improvements by speech aid appliance were unstable for deterioration after amelioration. However, the improvements by pharyngeal flap operation were stable or further improved. 3. Normal speech without nasality or articulatory error could not be achieved by speech aid application. On the other hand, 8 subjects with pharyngeal flap operation acquired normal speech. 4. Analysis by soundspectrograph confirmed the above results and showed better ameliorated pattern by pharyngeal flap operation than by speech aid application. 5. Nasality reduction was related to age and function of velopharyngeal muscle. The subjects, who were younger than 15 or able to move the muscle during phonation, were improved sufficiently by speech aid application or pharyngeal flap operation. Especially, the function of lateral pharyngeal wall is most related to nasality reduction. In all subjects who had the mobility of lateral wall during phonation, nasality disappeared after pharyngeal flap operation. The other subjects did not acquired desirable amelioration by speech aid appliance, but some of these were ameliorated by pharyngeal flap operation. 6. The efficacy of speech aid appliance was mainly related to its pharyngeal section and factors involving the subjects, and the efficacy of pharyngeal flap operation was thought to be ralated chiefly to operator's technique. Therefore, proper selection of subjects is thought the most important factor for speech aid application. Pharyngeal flap operation does not require any criteria for subjects, except for the problem of general contraindication for surgical operation. 7. Muscle stimulation of speech aid appliance was observed by radiocephalometric measurements in several subjects whom the speech aid appliance was applied over 2 months. On the bases of these results and training for articulatory correction and removability feature of the speech aid appliance, it is thought that the temporary use of speech aid appliance before pharyngeal flap operation is better procedure to ameliorate the efficacy after operation. When this procedure is employed, the selection of subjects is an important factor for its success.

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For the purpose of understanding the precise mechanism of staphylococcal infections in human mouth, the author deemed it worthwhile to investigate the possible correlations existing between the staphylococcal strains and some other kinds of organisms usually found in various loci in the mouth. The present paper presents some of the results of an epidemiological study on a total of 845 strains of staphylococci (106 of aureus and 729 of epidermidis strains) which were isolated from the nose, throat, saliva and tooth plagque materials of healthy individuals, and a total of 609 strains of staphylococci (180 of aureus and 429 of epidermidis strains) which were isolated from a variety of morbid sources in the mouth such as periodontosis, surgical lesions, infected root canals and periapical cystic lesions. The isolated organinsms from these sources were respectively characterized for the biological natures by routine methods and the phage typing was conducted on the strains of aureus species to secure more systematic classification. Distribution of both kinds of organisms from the above loci of healthy and morbid individuals was then determined and results were summarized as follows. 1. Healthy subjects usually carried an abundant population of Staphylococcus epidermidis and a small number of Staphylococcus aureus in a parasitic state in their nose, throat and salivary fluid. 2. Morbid materials from periodontosis and surgical lesions showed the presence of Staphylococcus epidermidis, accompanied by a small number of Staphylococcus aureus which was apparently responsible for the infection. 3. In those closed loci in the mouth such as infected root canal and periapical cyst, both Staphylococcus aureus and Staphylococcus epidermidis were present with generally epual abundance, but, in a few instances, the former organisms exceeded the latter in number. 4. The phage typing study conducted on two groups of aureus strains of Staphylococcus isolated from nose and throat region and from salivary fluid revealed that both groups of organisms were identical in the phage typing pattern showing the occurrence of I-type, II-type, and the mixed type of the former two. 5. The phage typing patterns of the isoltes from the infected root canal and periapical lesion were common in that the organisms were of I-III-mixed type. 6. According to the phage typing study on staphylococcal organisms isolated from the nose, throat and salivary flind of healthy individuals, I-type occurred most frequently, followed by III-type and I-III-mixed type in order, while with those from the morbid sources in the mouth, I-III-mixed type was most predominant, followed by III-and I-type in order. 7. Study on the distribution of staphylococcal strains isolated separately from the morbid sources of the mouth and from the mose, throat and salivary fluid of the same individual, revealed that a relatively small number of organisms were present in a parasitic state to cause infections in the former sources, and a similar number of organisms were present in the latter sources, but purely in a parasitic state. 8. Study on the distribution of individual phage types of organisms in both morbid sources and in the nose, throat and salivary fluid, revealed that both sources yielded the identical pattern of phage type distribution, I-type, III-type and I-III-mixed type being all present. The above study would seem to suggest that the organisms usually present in the nose and throat can readily migrate into the salivary fluid and can become the constant source for initiation of the primary and secondary infections in oral tissues and organs.

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昭和41年1月より, 昭和46年12月まで, 過去6年間にわたる, 九州歯科大学第2口腔外科学教室入院患者は, 総計1, 306例, 年平均217例となり, 男女それぞれ732例, 574例であった.年齢別では9才以下の若年者例が477例ともっとも多く, この現象は歯科口腔外科診療体系の一端を示すものとして興味深い。月別入院症例数では1月に入院がわずかに多く見られた以外特別の差は見られなかった。個々の疾患別に見た場合, 奇形, 炎症, 嚢胞性疾患, 悪性腫瘍, 良性腫瘍, その他の順となり, これらの各年別入院患者総数に対する割合はほぼ一定していた。入院日数では, 悪性腫瘍がもっとも長くほぼ3ヵ月の長期にわたった。この原因は悪性腫瘍に対し, 積極的に化学療法ことに動脈内持続注入法を採用しできるだけ, 外科手術による実質欠損を少なくするという治療方針も若干関係していると思われる。ベッド占有率では, 奇型と悪性腫瘍で60%以上を占め, これらの疾患の口腔外科学的臨床意義の重要性を改めて認識した.従って, この二つの疾患群を中心に, 他の疾患群についても検討を加えた.裂奇形患者の新鮮例では, 口蓋裂のみおよび唇顎口蓋裂例数が口唇裂のみのそれよりも約2倍であった.唇裂, 唇顎口蓋の口唇形成術はほぼ一才以前に行われ, 唇顎口蓋裂, 口蓋裂の口蓋形成術は大部分が2才以前に, おそくとも5才までにそのほとんどが行われている.なお, 46年度の口唇形成術の10例はLip Adhesionが施行され, この術式における予後は後日詳述する.悪性腫瘍例は裂奇形と対照的に40才以上の高齢者が多かった.しかし10才以下ことに2才の細綱肉腫症例は, 口腔外科学診断上配慮の肝要な一端を示すと思われる.男女比では, 男性が女性の2倍を示し注目される.悪性腫瘍の3年生存率の平均は, 36.7%であるが, もっとも症例数の多かった上顎洞癌の生存率に大きく左右されたものと思われた.かかる点が今後口腔領域悪性腫瘍に対する治療成績向上の重要なる一面である.ここに他疾患群も含め, 6年間の臨床統計の概要を報告する.

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We have experienced a case of epulis gravidrum at 31-years old woman, who was in the nineth month of pregnancy. The tumor have recurrenced three times in a few weeks, for period in this pregnancy. Its lesion occurred from buccal side gingiva on the part of premolar in the lower right, and had a sise of the tip of thumb and color of the yellowish red. Roentogenograms showed a little resorption of the interalveolaris between <5|>^^^- and <6|>^^^- region. The tumor was excised after dilivery with contiguous tooth and curetted the alveolar bone around extracted tooth and extracted the interalveolar bone. Postoperative observation have not showed any residual or recurrent after a year. Microscopic examintion showed increasing and enlargement of blood capillaries, and increasing the young tissue of granuration. Hist-pathological diagnose was epulis telean-giectaticum.

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During the dissection practice for students in 1972, the following variation muscles in bilateral Sternothyroids were encountered. No.249 : Age 61, male. 1. The bundle of extra muscle arisen from right Sternothyroid as a part of its muscle fibers ran in-and-upward along the lateral edge of right thyroid gland. Separated into two heads on the way, the medial head was inserted into loose connective tissue of carotid sheath which was anterior face of common carotid artery, the lateral head was inserted into loose connective tissue between internal and external carotid artery. 2. The bundle of extra muscle arisen from left Sternothyroid as a part of its muscle fibers ran upward along the lateral edge of left thyroid gland and was inserted into loose connective tissue of carotid sheath which was front part of common carotid artery.

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