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In order to evaluate the Th1 and Th2 responses of Oral Squamous Cell Carcinoma (OSCC) patients, we investigated the cytokine producing capability of peripheral blood (PB), and compared it with clinicopathological appearances of OSCC patients. The production of a Th1-type cytokine, interferon (IFN)-γ, from lipopolysaccharide (LPS)-stimulated PB correlated positively with the frequency of lymph node metastasis. We also investigated the production of a Th2-type cytokine, IL-10, however, no significant correlation was observed with the clinicopathological appearances. Our results suggested that the IFN-γ producing capability was specifically regulated and dependent on the regional metastatic potencies of OSCCs.

Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive neoplasm of the paranasal sinuses. SNUC is characterized by rapid expansion with high rates of recurrence and metastasis to cervical lymph nodes and distant sites. The patient was a 65-year-old woman who complained of persistant pain at the right maxilla. She had undergone endodontic therapy at the right first molar by her primary dentist. Imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI), showed a lesion occupying the right maxillary sinus and extending into the nasal cavity and ethmoid sinus. A malignant tumor of the maxillary sinus was suspected, and a biopsy was performed. The lesion was diagnosed as sinonasal undifferentiated carcinoma. The patient was treated with chemoradiation therapy. After 4 cycles of chemoradiation therapy, CT and MRI showed shrinkage of the lesion and changes consistent with necrosis. Histological examination of a repeat biopsy specimen after the 4 cycles of chemoradiation did not contain tumor cells. 2 more cycles of chemoradiation therapy were added. Six months after the initial diagnosis, CT finding suggested residual tumor in the ethmoid sinus. We performed another biopsy and the histopathological analysis was negative for tumor. The patient has been followed for 33 months since completing chemoradiation therapy, and there has not been any further evidence of disease.

Here we present a case of a 7-year-old Japanese girl with regional odontodysplasia af- fecting tooth numbers 24, 25, 26, and 27. No other teeth were affected. Partially erupted tooth number 26 had a rough enamel surface and was yellow-brown in color. Tooth numbers 24, 25, and 27 had not erupted. Radiographically, numbers 24, 25, 26, and 27 seemed to be undevel- oped with large pulp chambers, short roots, and open apices, and exhibited the so-called ghost- like appearance. Histopathologically, number 26 had uneven thin enamel and dentin, revealing hypoplasia and hypocalcification, and irregular dentinal tubes. The patient was followed up for 6 years and had similarity normal occlusion.

To elucidate the genetic events that occur during the development of OSCC, the present study established a model of oral malignancy using a mouse oral squamous cell carcinoma (OSCC) Sq-1979 cell line. Sq-1979 cells were implanted into syngeneic C3H mice. Subsequently, 233 cells and metastatic sub-clones (L cells) from primary OSCC, as well as the metastasized lymph node tissues of Sq-1979-implanted mice were established. Compared with parental Sq-1979 and 233 cells, the majority of L cells exhibited a higher proliferation rate and transplantability, and conferred a lower survival rate on the implanted mice. To investigate the genetic background of L cells, preferentially expressed genes in L cells were identified by cDNA microarray and reverse transcription-polymerase chain reaction analyses. The expression of FYN-binding protein (Fyb), solute carrier family 16 member 13 (Slc16a13), keratin 7, transmembrane portion 173 and Slc44a3 mRNAs was significantly elevated in L cells compared with that in Sq1979 and 233 cells. The mRNA expression was also evaluated in human OSCC and leukoplakia (LP) tissues. Among the 5 aforementioned mRNAs, the expression of FYB and SLC16A13 was significantly higher in OSCC than in LP tissues. Furthermore, the expression of SLC16A13 mRNA was significantly elevated in highly invasive OSCCs, which were classified as grades 3 and 4 by the Yamamoto-Kohama (YK) classification of invasion, compared with those in lower grades (YK-1 and -2). The model proposed in the present study could thus describe essential marker genes for the diagnosis of oral malignancies.

The present review introduces heterotopic bone formation, which may be classified into osteoma in the tongue, lipoma with osseous and chondromatous changes, fibrous dysplasia ossificans progressiva (FOP), myositis ossificans traumatica (MOT), Albright's syndrome, vascular ossification in atherosclerotic lesions, ectopic ossification of periodontal epulis, stromal bone formation in the tumors and soft tissue osteogenic tumors (extraskeletal bone tumors). Those ectopic ossifications are unusual conditions, and in the head and neck area, the tongue is the most frequent site of heterotopic osteoma or chondroma. The biologic mechanism of heterotopic ossification may be similar to those of normal ossification, however, pre-existing changes or the transformation into osteogenic cells from non-osteogenic stem cells might be important roles. The myogenic cells in skeletal and smooth muscles suggest they are frequently transformed to osteogenic cells compared to those of mesenchymal cells. Those processes will involve growth promotion factors. Ectopic ossification also mediates epithelial cells, keratinocytic BMP directly induced to trigger ossification, in the case of calcifying epithelioma Malherbe. Classic bone induction theory may also involved epithelial BMP.

Fetuin is an α 2 -Heremans–Schmid glycoprotein (α 2 -HS), a non-collagenous serum protein in human blood and calcified tissue. Fetuins form highly specific complexes, and fetuin matrix γ-glutamic acid (Gla) protein complex prevents the growth, aggregation and precipitation of calcified components. Fetuin binds to TGF-β/BMP, and the binding order is BMP-2 > BMP-4 > BMP-6 > FGF-β1 > TGF-β2. The biphasic osteogenic response to TGF-β1 suggests overlapping gradients of TGF-β1/BMP. Elevated serum fetuin levels are correlated with common features of osteogenesis imperfecta and patients with Albright osteodystrophy may use fetuin to prevent osteoblastic differentiation. Patients with Paget's disease, involving increased bone turnover, show depressed fetuin levels. Fetuin A is an important circulating inhibitor of calcification in vivo , and is down-regulated during the acute-phase response. There is a hypothesis that fetuin deficiency is directly related to uremic vascular calcification. At present, in cases of bone disorders (heterotopic ossification) for which there is no recommended surgery, such as Albright syndrome and vascular ossification, clinical use of fetuin might reduce the risk of extensive heterotopic ossification.

In order to improve the scientific outcome for bone surgery including fracture healing and bone remodeling processes after correcting facial bone or surgical bone loss, this review focuses on the biophysiology of transforming growth factors (TGF) and bone morphogratic protein (BMP) in the bone remodeling system. Surgical techniques involving the oral maxillofacial skeleton have advanced mainly from experience and experimental models as in traumatology or oncological surgery. Bone regeneration and calcification are performed at function balances for osteoblastic growth and osteoclastic resorption. Bone synthesis is mediated with differentiation of osteoprogenitor cells. This mechanism is concerned with various growth factors: i.e. TGF and BMP, and those associated factors, as growth differentiation factor 5 (GDF5), cartilage-derived morphologenetic protein (CDMP), noggin, chordin and connective tissue growth factor (CTGF). Except for TGF and BMP, the biological properties of other novel growth factors participating in bone forming activity have not been routinely introduced. The bone remodeling system is a complex phenomenon as well as varying growth factor system for osteoprogenitor target cells. The knowledge obtained from this review will benefit the healing processes and/or bone remodeling system following surgical procedures in the oral-maxillofacial area.

Objective The present study reviewed endothelin (ET) as an endothelial vasoconstrictor of three types: ET1, ET2 and ET3 and two receptors (ETAR, ETBR). They were involved in bone remodeling, developmental anomalies in the mandibulo-facial area and bone metastasis from cancer of distal organs. Review topics The tissue remodeling process has been recognized to have multiple growth factors including endothelins (ETs) and receptors (ETRs). Among ETs, ET-1 is the most potent vasoconstrictor, and it binds to ETAR or ETBR. The biophysiological roles of ETs and ETRs are involved not only in vascular tissues but also bone tissue. Promotion of bone formation through ET-1 will take place following dental implant, tooth extraction, destruction osteogenesis and surgical bone loss. ETs and ETRs mediate the normal development of craniovascular structure which eventually migrate to the pharyngeal arch. The CATCH 22 syndrome ( c ardiac defects, a bnormal facies, t hymic hypoplasia, c left palate and h ypocalcemia associated with chromosome 22 microdeletion) displayed developmental malformation (3rd and 4th arch). Treacher Collins syndrome, and Pierre Robin sequence and DiGeorge/Velocardic facial syndrome are resemble this CATCH 22 syndrome. Conclusions ETs and ETRs related to biological processes in bone remodeling have been beneficial in fracture healing, bone remodeling, orthodontic tooth movement, distraction osteogenesis, surgical or traumatic bone defects and bone metastasis. ETs and ETRs influenced the embryonal development of pharyngeal arch and congenital anomalies like the CATCH 22 syndrome.

Statins are a class of drugs widely used in the treatment of cardiovascular diseases to reduce hypercholesterolemia, and involve an increased prevalence of osteoporosis. Several studies suggested that statin mediates stimulation of bone remodeling. One of the statin family members was first isolated from Penicillin citrium (mevastatin), and another later from Aspergillus terreus (lovastatin). Roles of statins are mediated by competitive inhibition of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, such as inhibition of the mevalonate pathway. Statins have a potential antiinflammatory effect (IL-6), which may be related to promotion of bone growth and maintaining bone health. Statins in local use and general administration enhance osteoblastic differentiation and production of bone matrix proteins via bone morphogenetic protein 2 (BMP-2) signaling pathways. Clinical applications of statins have increasingly been reported for bone fractures and implant dentistry. The present review introduces biophysiological functions of the statin family in normal remodeling of bone tissues demonstrated by both in vivo and in vitro studies, and in promoting bone growth caused by osteoprotegerin production by statins with BMP-2.

Natriuretic peptides (NPs), guanylin, uroguanylin, heat-stable enterotoxin type a (STa), and the cystic fibrosis transmembrane conductance regulator (CFTR) are important regulators involving water and ionic balance in vertebrates. The present report points out the evolution of osmoregulatory systems and their effector organs, including the rectal glands of eels, frogs, and sharks; the salt glands of birds; and the salivary glands of mammals, including those of humans. Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and the activity of their respective receptors in the organs of vertebrates were reported as biological characteristics of heart hormone. This review focuses on Cl-/HCO3- exchange activity in the salivary gland ducts and ductal basal cells that express NPs and related regulators. This report describes published histochemical findings on protein and mRNA expression in ductal basal cells and the biological significances of those findings with regard to the mammalian salivary gland duct system and a number of growth factors synthesized in the granular convoluted tubules (GCT).

A 40-year-old female visited our department in June 2008 with chief complaints of intraoral denudation of the canine root, occlusion anomaly, and mastication disorder. She had a history of mandibular anterior subapical osteotomy and genioplasty by removal of the mandibular margin of the mental region under general anesthesia in another hospital in June 2007. In December 2007, an aperture was found at the osteotomy site and plate fixation was performed in the same hospital in January 2008. However, denudation of the canine root was found in February 2008 with a mastication disorder that had persisted since the initial surgery, which led her to visit to our department.At her initial visit, denudation of the canine root was confirmed. The right molars were missing and no contact was found in the anterior teeth. Skin mobility in the mental region was limited, indicating oral food intake without mastication. The patient was diagnosed as fissure fracture of the mandibular bone at the distal region of the lower left canine and faulty union of the alveolar osteotomy site.Alveolar osteotomy was repeated and the mandibular fracture was fixed under general anesthesia in September 2008. The cortical bone of the former alveolar osteotomy site showed faulty union. Following repeated osteotomy, the dentures were reconstructed by supporting them with preoperatively prepared plate splints and wire splints to check the occlusion, and then the osteotomy site was fixed with a miniplate. Iliac bone was grafted in the bone gap, and intermaxillary anchorage was retained for 20 days postoperatively. Following treatment, the occlusion in the anterior teeth improved and the patient was able to take regular food. However, continuous follow-up is necessary because of persistent partial denudation of the canine root and denudation of the grafted bone.In the diagnosis and treatment of jaw deformities to correct occlusion and masticatory functions, we consider that preoperative and postoperative occlusal management is important, especially when it appears to be difficult to obtain stability of postoperative occlusion.

The present paper provides a general review of the biophysiology of natriuretic peptides (NPs) in mammals. NPs, classified as hypotensive hormones, include atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP), as well as their receptors, which involve natriuretic and diuretic activity and also blood circulation and volume homeostasis. This review also summarizes the historical background of NP families and cyclic guanosine monophosphate (cGMP)-dependent protein kinase (cGK1) and their biological properties in cardiovascular tissues, heart diseases, renal functions and disease, respiratory and lung failure, gastrointestinal tissue, urogenital and reproductive organs, endocrine activities, the central nerve system, and bone tissue. ANP triggers natriuretic and diuretic activities in the kidney and alters the electrolyte balance via intestinal absorption of water and sodium ions. CNP is involved in promoting wound healing in arterial endothelial cells. The CNPR-related bone pathway plays a causal active role in bone anomalies, and is a regulator of longitudinal skeletal growth diseases such as achondroplasia. CNP-natriuretic receptor B (CNP/NPR-B) system has signifi cant role in the processes of enchondral ossification. Recently, osteocrin/musclin was discovered as belonging to the NP family; it binds with high affinity to NPR-C and plays a role in bone growth.

Salivary glands secrete saliva which contains mucins, antimicrobial substances and growth factors. Since epidermal growth factor (EGF) and nerve growth factor (NGF) were demonstrated in murine submandibular glands (SMGs), several growth factors and biologically-active peptides have been studied in the human or other mammalian salivary glands and saliva. These growth factors may have a functional role in cell migration, proliferation and maturation within not only salivary glands but also other organs. In the SMGs of mice and rats, EGF, NGF and other known growth factors are usually synthesized in granular convoluted tubule cells (GCT). However, human SMGs are devoid of GCT cells, and growth factors in human salivary glands are usually produced in striated ducts. These findings suggest an evolutionary trace of ductal cells in mammals. The present review describes expression patterns of the following salivary gland growth factors: nerve growth factor (NGF); transforming growth factor α and β (TGF-α/β) bone morphogenetic protein (BMP); insulin-like growth factor (IGF); fibroblastic growth factor (FGF); and somatostatin, as well as their receptors. This review also discusses their cell biological roles in pathophysiological conditions.

Bilateral sagittal split ramus osteotomy (SSRO) is commonly used to treat jaw deformities. The purpose of this study was to evaluate the postoperative course of patients that underwent SSRO from before operation to fiveyearsafteroperation.A total of 41 female patients with jaw deformities underwent SSRO and their masticatory functions and neurosensory recovery were examined with appropriate indicators pre-and posto-peratively. The control group consisted of 24 females with individual normal occlusion assessed as having normal masticatory function.The skeletal stability was well maintained for five years after the operation.The result was that masticatory function following orthognathic surgery showed a decline at one month after surgery, but gradually improved. Especially, the values of occlusal contact area and occlusal force reached the maximum level at four years after surgery. There were no significant differences between the levels of the patients and control subjects three to five years after surgery. The score of the Helkimo index for temporomandibular dysfunctions at one year after surgery was lower than that before surgery. However, this score increased from three years after surgery.The S-W sensory test was used for clinical sensory testing of the lower labiomental area, and differences in degree of sensory disturbance were statistically analyzed. Most patients experienced a marked sensory disturbance in the immediate postoperative period. These symptoms dramatically improved within one year after surgery. However, the result showed that recovery of sensation tended to be limited to within one year after surgery.

1990年から2003年に当科にて治療した異時性口腔多発癌10例に関して検討を行った。男性7例, 女性3例で初診時年齢は45～88歳で平均65.6歳であった。第2癌発生までの期間は16か月から10年1か月におよび, 平均5年5か月であった。組織学的には, ほとんどが高分化型扁平上皮癌で, 発育様式は前癌病変を伴なった表在型のものが多数を占めた。

Many reports describe how a foreign body was accidentally inserted into oral soft tissue during dental treatment. Sometimes it is very difficult to locate inserted foreign bodies, without damaging adjacent tissues. This report describes the use of a metal detector to locate metallic foreign bodies, such as an inlay, file, and knifepoint fragments, lodged in the oral or maxillary region (or both). The metallic detector (Implant Finder®, Degussa AG, Germany) is routinely used to look for fixtures under the gingival mucosa at secondary implant operations. Detection of materials was possible within a 10mm depth in principle, of objects such as dental metal, bars, and suture needles. Use of an Implant Finder® facilitated removal of foreign bodies, thus helping to avoid unnecessary incisions and dissection of other parts. Postoperative recovery was excellent, without nerve damage or recurrence of inflammation.

Objective: To measure the labio-lingual bone thickness in the mandibular interforaminal region to facilitate safe implant placement in Asian patients. Materials and Methods: Labio-lingual bone thicknesses were measured at 16 points in the interforaminal region of mandibles from 10 Japanese cadavers. Results: Mean thickness ranged from 9.23 to 11.80 mm with a minimal value of 5.23 mm in the midline region. No significant difference was noted between dentate and edentulous specimens. Conclusion: The thinnest region is medially located and is narrower than the minimum required for a 3.75 mm diameter endosseous implant.

The subset of T-cells positive for expression of cluster of differentiation (CD) 57 has been associated with various cancer phenotypes. However, the presence of CD57(+) T-cells in patients with oral squamous cell carcinoma (OSCC) has yet to be confirmed. In the present study, we examined the diagnostic significance of the presence of CD57(+) T-cells in peripheral blood (PB) from patients with OSCC.The subset of CD57(+) T-cells in PB was analyzed in 43 patients with OSCC by fluorescence-activated cell sorting (FACS) analysis.The proportion of CD57(+) T-cells, including both CD8(+) and CD4(+) subsets, significantly increased with clinical stage, especially in parallel with tumor size.Our results suggest that an increase in the population of CD57(+) T-cells is a potent prognostic marker and may also influence the systemic immunity of patients with OSCC.

We have developed the fluorescence diagnostic apparatus of oral lesion. In this study, we analyzed autofluorescence of SCC and leukoplakia. Both cases of SCC and leuk oplakia, we found two fluorescence peaks. In case of SCC, a major peak was at 628 nm and a smaller peak was at 668 nm. As regard to intensity, the maximal intensity of SCC was 18 times stronger than that of normal oral mucosa. In case of leukoplakia, a major peak was at 658 nm and smaller peak was at 627 nm. The maximal intensity of leukoplakia was five times stronger than that of normal oral mucosa. The results suggested that the autofluorescence diagnosis of oral lesion would be possible by new fluorescence diagnostic apparatus.

Introduction: Facial asymmetry has been one of the important themes in jaw deformities.The course of treatment for jaw deformities is usually decided in response to cephalometrical analysis, but it is difficult to suspect the movement of soft tissue after surgery. In this paper, asymmetry, caused by the buccal lipoma discovered postoperatively, is discussed.Case: A seventeen-year-old female visited Hamamatsu University Hospital in 1991 with maxillary retrusion, mandibular protrusion, and facial asymmetry diagnosed cephalometrically. After preoperative orthodontic treatment, Le Fort I osteotomy and ramus sagital split osteotomy were carried out in September 1993. After surgery the cephalometrical asymmetry was improved, but her cheek remained swollen. The excess tissues of the cheek, especially the right buccal fat pad, was thought to be the cause because there were no other abnormal findings such as induration. Then the buccal fat pad was partially removed when the miniplates were removed. However, the facial asymmetry of soft tissue was not improved. After taking a CT and an MRI, the right buccal lipoma with capsule was found. In March 1996, the lipoma was resected, and as a result, her facial asymmetry was corrected.Discussion: Facial asymmetry is caused by hard tissue and/or soft tissue. In consideration of the incidence of asymmetry among the jaw deformities and the incidence of lipoma in the maxillofacial area, such as this case, soft tissue tumors such as lipoma are thought to be possible causes of facial asymmetry. When evaluating facial asymmetry, especially in cases of facial asymmetry of soft tissue remaining postoperatively, an image diagnosis such as a CT or an MRI should be utilized.Conclusion: Since soft tissue tumors such as lipoma are possible causes of facial asymmetry, facial asymmetry should be examined carefully.

Oral squamous cell carcinoma (OSCC) is an aggressive malignancy which shows a variable degree of malignant behavior. To identify molecular signatures and establish a new diagnostic model for oral malignancies, we have identified marker genes representing pre-malignant and malignant phenotypes of oral mucosal lesions. The expression of marker genes was examined by quantitative reverse transcription-PCR. Then, we created discriminatory predictor models using Fisher’s linear discriminant analysis and leave-one-out cross validation. These models were applicable for the diagnoses of pre-malignant leukoplakias (LPs), and of invasion status for advanced OSCCs. The clinical course of various cancers is also influenced by host immune response. Our preliminary data using flow cytometric analysis demonstrate that the percentage of CD4+CD57+ T cells in peripheral blood lymphocyte was higher in the high grade OSCCs than that in the low grade ones. Furthermore, lipopolysaccharides (LPS)-induced ex-vivo production of Interferon (IFN)-γ from peripheral blood cells was highest in stage I patients and gradually decreased during the course of OSCC progression up to stage III. These decreased levels in the early stages were inversely correlated with tumor size. In this review, we propose that the usage of the immunological status of OSCC patients combined with the molecular signatures of tumor tissues could provide valuable indices for diagnosis of oral malignancies.

Questionnaires were sent to oral and maxillofacial surgery, orthodontic and anesthesiology departments where board members of Japanese Association of Oral and Maxillofacial Surgeons, Japan Orthodontic Society, or Japanese Dental Society of Anesthesiology are working. Questionnaires included questions on surgical procedures for mandibular deformities, fixation methods between segments, the duration of postoperative intermaxillary fixation, complicatison of perioperative phase, and preoperative and postoperative orthodontic treatments.This paper, as part 3 of this study, presented the results of the survey on factors affecting perioperative management of patients, intraoperative and postoperative complications, and malunion of segments based on the replies from 10 anesthesiology departments and 99 oral and maxillofacial surgery departments.The results were as follows:1. Thirty-four out of 71 oral and maxillofacial surgery departments suggested preoperative orthodontic treatment, the number of the teeth remaining in the oral cavity, and the size of the tongue as the most important local factors for the success of orthognathic surgery in the treatment of mandibular deformities.2. Systemic diseases influencing surgical risk in general anesthesia were given as factors compromising perioperative patient management.3. Sixty out of 87 oral and maxillofacial surgery departments experienced intraoperative complications. Thirty-five experienced excessive bleeding and unintentional fractures of segments during sagittal splitting osteotomy. Several departments reported experience of damage to the inferior alveolar neurovascular bundle and the facial artery and vein.4. Seventy-six out of 90 oral and maxillofacial surgery departments reported postoperative complications. Anesthesia of the lower lip was reported by 45 departments. Infection, temporomandibular joint dysfunction, bleeding and facial nerve palsy were reported by several departments.5. Sixteen cases of malunion between osteotomized segments were reported by 16 oral and maxillofacial surgery departments. Twelve departments reported the surgical procedures, in which seven were sagittal splitting osteotomy and five were ostectomy of the mandibular body.

All of the subjects that had been presented during the last 14 years in Japanese Study Group of Jaw Deformities, which was recently renamed Japanese Society for Jaw Deformities, have been reviewed in detail.The results were as follows: 1) It is time to improve the typical operative methods. 2) Treatment of jaw deformity with the medical complications, failure cases, and long-term observed cases must be investigated. 3) Although there were many clinical presentations at the beginning, the number of basic research presentations have been increasing. 4) It seems that a long time would be required to elucidate causes and pathological conditions of jaw deformities as well as to establish preventive measures. Therefore, the current therapeutic methods, that is, “preoperative orthodontics-operation-postoperative orthodontics”, would continue to be the main stream.We would like to establish the institution as, “Center for Jaw Deformity” to research causes and methods of treatment for severe jaw deformities. An orthognathic surgical system controlled by medical electron machines and nonsurgical treatment is expected to be developed in the future.

The effect of the proteolytic cleavage of plasminogen activator inhibitor type 1 (PAI-1) by human neutrophil elastase (HNE) on fibrinolysis was investigated. HNE cleaved active PAI-1 and produced low molecular weight forms of inactive PAI-1, as previously reported. Latent PAI-1 was resistant to HNE treatment. Vitronectin (VN) partially protected the cleavage. NH2-terminal sequence analysis indicated that the cleavage site was Val355-Ser356 (P4-P3). The effects of PAI-1 cleavage by HNE on clot lysis was studied in a purified system. Clot lysis time without PAI-1 was 20.0 +/- 5.0 minutes and was prolonged to 86.7 +/- 2.9 minutes by 68 nmol/L of PAI-1. It was shortened when HNE (from 0.6 nmol/L to 80 nmol/L) was added and returned to the value obtained without PAI-1 by 80 nmol/L of HNE (20.0 +/- 5.8 minutes). However, in the absence of PAI-1, elastase did not enhance clot lysis at all. Euglobulin clot lysis time was also shortened after HNE treatment. The cleavage and inactivation of PAI-1 by HNE was shown to be a novel pathway to enhance fibrinolysis.

Questionnaires were sent to oral and maxillofacial surgery, orthodontic, and anestheisology departments where board members of Japanese Association of Oral and Maxillofacial Surgeons, Japan Orthodontic Society, or Japanese Dental Society of Anestheology are working. Questionnaires included questions cocerning surgical procedures applied to mandibular deformities, fixation methods between segments, the duration of postoperative intermaxillary fixation, complications of perioperative phase and preoperative and postoperative orthodontic treatments. This paper presented the results of the survey on surgical procedures, fixation methods between segments and the duration of intermaxillary fixation based on the replies from 99 oral and maxillofacial surgery departments.Results1. Sagittal splitting ramus osteotomy is widely used for the treatment of mandibular deformities in oral and maxillofacial surgery departments of Japan, and 89 out of 93 oral and maxillofacial surgery departments apply this procedure to the most of their mandibular deformity cases.2. Three departments use vertical ramus osteotomy for the treatment of mandibular deformities in more than 50% of their cases and 18 departments use this procedure in the second largest number of their cases.3. Intermaxillary fixation is used postoperatively in most departments. Some departments apply it for more than six weeks even if rigid bone fixation methods are used.4. Most of all oral and maxillofacial surgery departments have been trying to reduce the duration of intermaxillary fixation by applying more rigid methods for securing segments.

Trisomy 13 syndrome is a congenital disease with various deformities. Clinical characteristics are diverse, and the prognosis is extremely poor.A 25-day-old girl whose parents were Brazilian visited our department because of bilateral cleft lip and palate.We found bilateral cleft lip and palate, a ongenital tooth in the mandibular incisor region, and micrognathia. A chest radiograph showed spina bifida and dextrocardia. A CT scan showed cerebral hemorrhage. Chromosomal examination showed trisomy 13 with translocation.We describe and discuss this patient with trisomy 13 syndrome in whom we performed cheiloplasty at the strong request of the parents, despite a poor prognosis.

Porous blocks of carbonate apatite (CA) were prepared by holding together CA particles ranging in size from 300 to 500 microm through sintering at 750 degrees C for 2 hours. Bone marrow cells taken from Fischer rats were seeded onto and inside the CA blocks and cultured for 14 days to allow stem cells to proliferate to osteoblasts capable of inducing bone formation. Hybrids made of CA blocks and cultured bone marrow cells were then implanted into the back of syngeneic rats. Microfocus x-ray computed tomographic images of tissues containing CA blocks before decalcification suggested that new bone was formed in this extraosseous site 4 and 8 weeks after implantation. These data indicate that the hybrid made of CA and bone marrow cells is capable of inducing heterotopic bone formation in vivo.

The sagittal split osteotomy of the mandible is widely used for the correction of various dentofacial deformities in Japan but was some problems to apply it to Japanese women whose mandibular ramus are small and thin.From these reasons, we developed a modified technique of the procedure that the mandibular ramus was cut by a reciprocating bone saw with minimal split, and osteotomized segments were fixed monocortically with titanium miniplate and screws placed by Angular screwing instrument® on each side without skin incision.Based on our experience of 30 cases treated by the procedure from September 1989 to December 1990, following merits are obtained.1) Bone cut is safer and easier and cutting surfaces become flat and smooth because of minimal split.2) Placement of miniplate and screws is made easily by Angular screwing instrument® without skin incision.3) A sharp angle at the second molar region made by bone cuttings allows the sufficient rigidity of the monocortical fixation between segments by one miniplate and screws.6) Postoperative adaatation to the new occlusion is rapid because the duration of the maxillo-mandibular fixation decreases significantly.

A case of mandibular prognathism with Marfan's syndrome treated with sagittal splitting ramus osteotomy was presented.A 37 year-old man, complaining of difficulty of mouth opening was referred to our clinic. The patient was diagnosed as bilateral temporomandibular joints arthrosis with mandibular prognathism.Although occlusal treatment with bite splint was effective to some extent, intermittent trismus did not disappear, so bilateral sagittal splitting ramus osteotomy was performed to correct his dental malocclusion.Postoperative course was not eventful and his range of mouth opening increased to 35mm between incisal edges of maxillary and mandibular central incisor.

約30年という非常に長い臨床経過を有した耳下腺腫瘍が悪性変化を示すとともに, 偶然発見された胃癌と同時発生的に重複した興味ある1症例を報告する。患者は76歳, 男性で, 1986年に右後頬部の自発痛を主訴に当科を受診した。右頬部から耳下腺部に巨大な腫瘤があり, 顔面神経麻痺症状がみられた。入院待ちの間に, 突然の吐血で発見された胃癌のため胃亜全摘出術を受けた後, 耳下腺腫瘍切除術を施行したが, 術後3か月で悪液質のため死亡した。耳下腺腫瘍の病理組織学的診断は, 分化の悪い (高悪性型の) 粘表皮腫であったが, 多形性腺腫内癌との鑑別診断に苦慮した。

An experimental psychological study was undertaken to assess the effect of a change in dietary habit upon behavioural development, using as a laboratory animal male Wistar rats maintained on natural foods and a processed food. Forty male Wistar rats were weaned at 21 days of age and divided into two equal groups. Group 1 was fed natural food (pressed wheat, dried fish, peanuts, cabbage and soybeans) and group 2 was fed powdered food. At 68 days of age, the rats were tested in a T-maze. The results showed that Group 1 excelled with regard to T-maze learning.

Lingual mandibular bone concavities were first described by Stafne in 1942 as cystic bone cavities situated near the angle of the mandible on roentgenogram.A case of lingual mandibular bone concavity in the region of the lower right premolars is reported in this paper along with a review of the literature.The subject was a 39-year-old man. He appeared at our clinic on 5/12/'89, having been referred to us by his general dentist with X-ray findings showing radiolucent lesion of the mandible.We suspected the mandible cyst. In the operative findings, we did not recognize a cyst wall in the mandible. We picked fragments of the soft tissue at the lingual mandible. The pathological findings of these tissues were normal muscle tissue, fibrous connective tissue and fatty tissue.In consideration of the clinical, operative and pathological findings, we thought that this radiolucent lesion was a lingual mandibular bone concavity.