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インスリン非依存型糖尿病患者1,000例 (男性467例, 女性533例) を対象として, 神経障害と肥満度との関連について検討した. 神経障害は, 四肢の自覚症状と自律神経症状の有無を対面法にて聴取し, さらにアキレス腱反射および生理学的神経機能検査を可能な限り実施し症状と検査の両面から判定した. また肥満度は, 日本肥満学会方式に準拠してBMIを指標として判定した.その結果, BMI24以上の肥満者においては, BMIが20から24の正常体重者に比して四肢の自覚症状の頻度やアキレス腱反射消失者および振動覚異常者の頻度が高かった. 両群の間には治療法, 血糖コントロールには差がなかったが, 罹病期間は肥満者でむしろ短かった. これらのことより, 肥満は神経障害の発症に対して早期から促進的に作用すると考えられた.またBMI20未満のやせ型の患者においても, 正常体重者に比して四肢の自覚症状やアキレス腱反射消失者および神経伝導速度異常者の頻度が高かった. 両群間で血糖コントロール, 罹病期間には差がなかったが, やせ型者ではインスリン治療者の頻度が高く, 病初期からの糖尿病の重症度が神経障害の発症に関与したものと考えられた.以上より, 糖尿病性神経障害の発症と肥満度には関連があり, 発症防止には適正な体重管理が重要と考えられた.

We immunohistochemically studied proliferating cell nuclear antigen (PCNA) in 25 oral squamous cell carcinomas. PCNA-positive cells were detected in all formalin fixed, paraffin embedded specimens. The results were as follows:1. The PCNA-positive rate in the group with cervical lymph node metastasis was significantly higher than in the group with no metastasis (p

Fibrotic gingival enlargements induced by phenytoin or nifedipine were examined with special reference to type VI collagen expression. Immuno-localization studies showed abnormal accumulation of type VI collagen around the collagen fiber bundles in the fibrotic gingival enlargements. Examination of total RNA extracted from fibroblasts and tissues of enlarged gingivae demonstrated increased type VI collagen steady-state mRNA levels. These results suggest that excessive deposition of type VI collagen in drug-induced gingival enlargement is attributed to increased expression of the collagen genes.

腺様嚢胞癌は, 頭頸部のいかなる部位にでも発生するが, その発生頻度は比較的まれな腫瘍である。特に, 舌下腺原発腺様嚢胞癌の症例報告はまれである。本報告では, 高齢者に発生した舌下腺原発腺様嚢胞癌を報告した。80歳・男性が左側口底から舌にかけての知覚麻痺と硬結を主訴として来科した。左側口底に, 約27×15mmの弾性硬, 不動性の腫瘤を認めた。臨床診断を左側口底悪性腫瘍とした。試験切除時の病理組織像は, 腺様嚢胞癌であった。全身麻酔下に, 気管切開術・局所拡大切除術・上頸部郭清術をおこなった。術中, 神経周囲浸潤が疑われたため, 舌神経および舌下神経を切除した。また, 顎下およびオトガイ下リンパ節転移が認められたが, 高齢者であったため, 上頸部郭清にとどめた。欠損腔は残存舌にて閉鎖した。術後, 放射線治療が選択された。局所および頸部リンパ節は制御されたが, 術後観察中に多発性微小肺転移が認められた。摘出物の病理組織像は, リンパ節転移・静脈侵襲・神経周囲浸潤を伴った舌下腺原発腺様嚢胞癌であった。本邦における文献では, 本症例を含めて18例の舌下腺原発腺嚢胞癌が報告されている。一般的に, 舌下腺原発腺様嚢胞癌は, 頸部郭清術と局所拡大切除がおこなわれている。しかし, 高齢者では術後の合併症や機能障害の防止のために, 局所切除および頸部郭清は制限される。

In the present study, we examined SBA lectin binding sites and patterns in hyperplastic dental epithelium overlying the crowns of pathologically unerupted molar teeth from congenital osteopetrotic (OP/OP) mice, and compared our findings with the pattern seen in the normal littermates. The hyperplastic dental epithelium of OP/OP mice disclosed preferential and intense staining of SBA. The lectin binding sites were demonstrated on membrane of the epithelial cells that interconnected with superficial gingival epithelium. At ultrastructural level, SBA labeling was detected over the desmosomal complexes of the epithelial cells. In normal mice, the reducing dental epithelium, as well as junctional epithelial cells, likewise demonstrated the lectin staining, but to a significantly lesser extent. The results of this study, taken together with suggested property of SBA binding, indicate that the hyperplastic dental epithelium in OP/OP mice might overexpress sugar sequences with N-acetyl-D-galactosamine on their cell surface, and this may be attributed to a functional alteration or degradation of such cell surface, due secondary to the pathological aberrations residing in OP/OP mice.

Summary A cylindrical cell papilloma occurring in the sino-nasal mucosa of a 61-year-old woman was studied histochemically at both light and electron microscopic levels. The cylindrical cells demonstrated distended intracytoplasmic microcysts with numerous microvillous projections on the apical cell membrane. The retained mucosubstance in the cystic spaces stained intensely with HID-TCH-SP sequence and showed no apparent communication with the extracellular space. These findings indicate that the cylindrical cells may be of mucous-secreting cell derivation, being derived from cells possessing abnormal and/or failed secretory function. The property of sulfated mucin in the 'cylindric' intracytoplasmic cysts is suggested to be the result of endodermal displacement or metaplasia of the Schneiderian epithelium.

We experienced 5 cases of neurogenic tumors and 1 case of granular cell tumor in the 10-ear period from 1982 to 1991. It is well known that neurofibroma and neurilemmoma are neurogenic tumors. On the other hand, granular cell tumors were first described as ‘granular cell myoblastoma ’ by Abrikossoff in 1926. Recently, ultrastructural and immunohistochemical evidences in favor of a Schwann cell origin have been published. In this study, four neurilemmomas, one neurofibroma, and one granular cell tumor were examined with antisera directed against S-100 protein, neuron-specific enolase (NSE), and vimentin.All of these tumors stained with antisera for S-100 protein and vimentin. NSE was absent from all of the tumors except for one case of neurilemmoma and the granular cell tumor. The immunohistochemical reaction pattern was heterogeneous, as follows;1. In the neurilemmomas, almost all tumor cells had a diffuse immunoreaction product indicating S-100 protein and vimentin in their cytoplasm and nuclei.2. In the neurofibroma, the staining pattern of S-100 protein and vimentin was similar to that of neurilemmoma: however, there were also a large number of S-100 protein-negative, spindle-shaped cells.3. In the granular cell tumor, cytoplasmic granules showed S-100 protein and NSE localization, and the peripheral cytoplasm showed the presence of vimentin. This staining pattern appears to be a characteristic feature of the granular cell tumor.

The incidence of sialolithiasis in the parotid gland is usually lower than that of the submandibular salivary gland.Recently, we encountered a case of parotid sialolithiasis and examined the component elements of the calculus.The patient was a 65-year-old man who came to our department with the right parotid gland swelling. After clinical investigations, the calculus were removed and examined with X-ray microanalyzer and X-ray diffraction analyzer.The calculus were composed of Ca, P, S, Mg, I, Na, K and Cl, and had hydroxyapatite-like structure.

腺房細胞癌は唾液腺に発生するまれな腫瘍であり, 全耳下腺腫瘍の2～4%を占める。上唇粘膜に発生した腺房細胞癌の1例を報告し, 文献的考察を行った。44歳の男性が右側上唇の無痛性腫脹を主訴として当科を受診した。局所のリンパ節腫脹は認められなかった。腫瘍は初診時に約20×20mmの大きさであり, 病理組織学的には腺房細胞癌であった。全身麻酔下に, 腫瘍を口腔内より根治的切除し, 分層植皮にて再建した。術後, 再発および転移は認めていない。1955年から1991年までの, 日本での文献では54例の小唾液腺由来の腺房細胞癌が認められた。好発部位は口蓋 (19例) であった。次いで, 臼後三角部 (9例) , 口唇 (7例) , 頬粘膜 (7例) , その他 (12例) に発生していた。文献例による再発率は21.6%であった。

Gene expression of matrix metalloproteinase 3 (MMP-3 = stromelysin) was examined in the skin fibroblasts obtained from patients with severe recessive dystrophic epidermolysis bullosa (RDEB). Steady-state mRNA level of MMP-3 was selectively increased in the unstimulated RDEB cells by a post-transcriptional mechanism. A parallel study on the susceptibility of type VII collagen to MMPs revealed that this type of collagen is degraded by MMP-3, but not by MMP-1 (collagenase). These data suggest that MMP-3 may play an important role in the blister formation fo the skin in RDEB patients by the degradation of anchoring fibrils consisting of type VII collagen.

Granular cell tumor of the tongue in a 67-year-old woman is reported including details of histochemical, immunohistochemical, and ultrastructural findings.The patient had a chief complaint of a painless nodule that was located slightly right of the midline of the tongue. The nodule, about 4 mm in diameter and having a distinct border, palpated hard-elasticity, and adhered to the muscle layer. Clinically, this tumor was suspected to be benign. The nodule was excised with the surrounding tissue under local anesthesia. The postoperative course is uneventful at present without any evidence of recurrence. The tumor was characterized by acidophilic granules in the cytoplasm. Marked pseudoepitheliomatous hyperplasia of the overlying epithelium was not present. Pathological diagnosis was a granular cell tumor.Histochemically, intracytoplasmic granules were faintly positive in the PAS staining, which was diastase resistant, and negative in the Sudan III and Sudan Black stainings. Immunohistochemically, the tumor cells were moderately positive by reacting with antiserum against S-100 protein, Electron microscopically, granules of various sizes in the cytoplasm of the tumor cell, which was bound by a basement membrane, were revealed, and occasionally myelin figures were noted. According to these results, the tumor cells were suspected to be neurogenic in origin.

Light and electron microscopic immunocytochemistry was used to localize S-100 protein. It was demonstrated in chondrocytes of the proliferative and hypertrophic zones but none could be found in the fibrous articular layer. The staining intensity for S-100 protein was stronger in the hypertrophic cells than in chondrocytes from the proliferative zone. Ultrastructurally, immunoreactive gold particles were detected in the cytosolic region, closely apposed to the profiles of endoplasmic reticulum with occasional dense aggregations. A few gold particles were seen on the nuclear chromatin and on condensing vacuoles of Golgi complexes. Because of the calcium-binding and possibly fatty acid-binding properties of the protein molecule, the immunocytochemical expression of S-100 protein in the chondrocytes may be involved in cartilage cell differentiation, metabolism and mineralization

Binding of wheat germ agglutinin to rat mandibular condylar cartilage was investigated with the avidin-biotin peroxidase complex. Binding sites were observed in the pericellular matrix of the hypertrophic cell zone. Two distinct patterns were identified: one showed binding to the pericellular matrix without apparent contour; in the other binding was confined to the matrix but with conspicuous condensation forming a pericellular rim. The first binding pattern was seen particularly in the upper part of the hypertrophic cell zone adjoining the mature cell zone; the second was localized in the lower part of this zone adjacent to the site of endochondral calcification. The binding sites in the pericellular matrix are assumed to be NANA and/or GlcNAc in view of the sugar specificity of this lectin. The presence of these binding sites in this region may be due to a structural alteration or modification of proteoglycans in the course of preparation for endochondral calcification.

We recently experienced three cases of benign cementoblastoma occuring in the mandible. Case 1 was a 37-year-old female with the lesion involving the apex of the right lower first molar. Case 2 was a 31-year-old female with the lesion involving the apex of the left lower impacted wisdom tooth. Case 3 was a 46-year-old female with the lesion involving the apex of the right lower first molar. Under the clinical diagnosis of cernentoma, tumor excision and tooth extraction were performed in all cases.On histopathological examination, the excised section showed a mass of cementum-like structure or was composed of mature cementum. Also, the calcified mass was surrounded by cementoblast cells and the postoperative courses in the three cases were uneventful without any sign of recurrence.

Weathers and Callihan, in 1974, referred to fibromas or fibrous lesions of the oral mucosa as “giant cell fibromas.” These lesions exhibit numerous large stellate cells and multinucleated giant cells histologically, discriminating them from usual fibromas.Giant cell fibromas have several interesting clinical and histopathological features, however, only a few of these lesions have been reported. This paper describes a case of giant cell fibroma that appeared on the lingual gingive of the lower jaw in a 3 year old male.

Neurofibroma which is often multiple is one of the symptoms of von Recklinghausen's disease. Solitary development of neurofibroma in the oral cavity is rare. We encountered a patient with a solitary neurofibroma that occurred on the gingiva. The patient was a girl aged one year and one month. She was introduced to our department due to swelling of the upper median gingiva. A swelling was detected in the cervical gingiva labially to the left upper deciduous central incisor. It was smooth on the surface, semi-spherical and elastic, and measured 5 mm in diameter. The swelling was clinically diagnosed as an epulis and was surgically excised under general anesthesia two months later. The resected lesion was spherical and not clearly encapsulated. Hyperplasia of small, thin collagen fibers mixed with fibroblasts was histologically found. The lesion seemed to be neurogenic. It reacted positively to immunohistochemical staining with S-100 protein.

In 1966, Johnson and Helwig called attention to a solitary cutaneous lesion thatthey termed “cutaneous focal micinosis”. These lesions occurred on the skin of the face, trunk, or extremities as nodules or dome-shaped elevations. They were characterized histologically by a mucinous accumulation interspersed with spindle-shaped fibroblastsSimilar lesions occurring in oral soft tissue were designanted as oral focal mucinosis by Tomich in 1974. Oral focal mucinosis and myxoma of the oral soft tissue were differentiated by the presence of reticulin fibers and a distinct border with the surrounding connective tissue.A 70-year-old man visited our clinic after noticing swelling of his buccal mucosa. The lesion was the same color as the surrounding mucosa. The resected lesion measured 15×15×10mm, and its sectioned surface Was smooth and grayish-white in color. Routine histochemical observation of paraffin-embedded tissue sections led to a diagnosis of oral focal mucinosis.

This paper describes a case of epidermoid carcinoma originating from the gingival sulcular epithelium with proper plane of histopathology. Relevant articles on carcinoma of gingiva are briefly reviewed, and the necessity for early diagnosis of this lesion is emphasised.

An ameloblastic fibrosarcoma (AFS) arising in the maxilla of a 14-year-old male is described. The tumor originated from the alveolar bone of the right maxilla with no apparent history of pre-existing lesion. Histologically, the lesion was composed of benign-appearing epithelial islands and strands scattered within an exceedingly cellular mass of mesenchymal tissue comprising a large number of stellate-and spindle-shaped fibroblast-like cells with marked pleomorphism. Occasional cementum-like calcification was also noted. Immunohistochemically, the neoplastic mesenchymal cells were positive only for vimentin, whereas the ameloblast-like epithelial component showed a distinctly positive reaction for wide-spectrum keratin and squamous cytokeratin. Clinicopathological features of the current case, as well as previously reported examples of AFS originating from the maxilla, are briefly discussed.

Epiphyseal growth plate cartilages from the proximal tibia of normal, hypophysectomized, and growth hormone (GH)-treated hypophysectomized rats were subjected to immunohistochemistry for detection of epidermal growth factor (EGF). In the normal growth plate, EGF was distributed mainly in the proliferative zone. Hypophysectomy resulted in considerable atrophy of the chondrocytes and the cartilage matrix (a decreased number of mature-type chondrocytes and a decreased ratio of proliferating to hypertrophic chondrocytes) and a significant diminution of EGF immunoreactivity. Treatment with GH reversed these effects of hypophysectomy, causing an increased thickness of the growth plate and EGF-reactive sites in all chondrocyte layers. The most intense immunostaining for EGF, however, was frequently seen in the nuclei of chondrocytes with flattened appearance. It appears that EGF could be incorporated or synthesized in chondrocytes having marked mitogenic activity. The present results, taken with previous data on EGF involvement in growth of cartilaginous tissue in vivo and in vitro, strongly suggest that EGF-immunoreactive chondrocytes are involved in cartilage proliferation and growth under the specific influence of GH.

A case of an unusual neoplasm of the buccal mucosa nearly identical to an ameloblastoma is reported. The tumor probably arose from the overlying squamous epithelium in the vicinity of the parotid duct.

Verruciform Xanthoma with histopathological characteristics of verruciform growth and the proliferation of xanthoma cell in the lamina propria was first described in 1971 by Shafer as Histiocytosis-Y. Though occasionally reported later in occidental countries, this disease is relatively rare. Especially in Japan this disease is rarely documented. The gingiva is a common site of occurrence. Those occurring in the tongue or buccal mucosa are very rare. Recently we encountered a 64-year-old woman with this disease in the left lateral margin of the tongue.

In our country, ameloblastoma is a typical tumor occurring in the oral cavity. The lower jaw is the usual site and upper jaw incidence is relatively low.A follicular dental cyst-like lesion in right maxillary sinus was recently experienced. Extirpation of the lesion site, sinuectomy and ethmoidectomy were performed based on Caldwell-Luc's radical operation.Postoperative histopathological examination showed that the excised cyst-like lesion contained a plexiform type ameloblastoma. The final diagnosis of a mural ameloblastoma was established by operative finding and histopathological examination. Since the mural ameloblastoma of the maxilla is very rare in existing literature, it is presented in this paper.

The effect of transferrin was tested on osteoblastic cells (clone MC3T3-E1) cultured in serum-free medium containing 1% bovine serum albumin (BSA). Transferrin (Tf) stimulated increases of protein content and protein synthesis, but not of DNA content and cell number, in the cells. This protein also increased alkaline phosphatase activity and collagen synthesis in combination with 1% BSA. Actinomycin D and cycloheximide inhibited alkaline phosphatase activity induced by Tf, suggesting that Tf may enhance de novo synthesis of the enzyme. These results indicate that Tf may be involved in differentiation of osteoblastic cells, but not in their proliferation, in vitro.

Myxoma is a. comparatively rare disease occurring in jaw bone. We encountered a 17-year-old girl who developed odontogenic myxoma from the region of the right lower second premolar to the right mandibular ramus.The patient appeared at our department with gingival swelling at the right lower molar region.Biopsy revealed histopathological evidence of odontogenic epithelium and myxomatous tissue.The lesion was managed by mandibulectomy under general anesthesia, immediately followed by reconstruction using A-O reconstruction plate and iliac bone autograft. This surgical intervention was satisfactory. No recurrence was found 4 years after surgery. Ninety-eight cases of myxoma of the jaw reported in literature were reviewed and the present case was comparatively discussed.