Gerald L. Schall

Salivary gland immunoglobulin and rheumatoid factor synthesis in Sjögren's syndrome: Natural history and response to treatment

Abstract Labial salivary glands, like the major salivary glands, are infiltrated with lymphoid cells in Sjogrens syndrome (SS). Studies utilizing biopsy specimens from the lower lips of seventy-six patients, forty-one of whom had Sjogrens syndrome, demonstrated that local synthesis of large amounts of immunoglobulins (IgM and IgG) and rheumatoid factor in salivary glandular tissue is distinctive for Sjogrens syndrome. The presence of rheumatoid factor was demonstrated autoradiographically by interaction between anti-lgG:lgG complexes and labeled immunoglobulins. Rheumatoid factor in the lip was found in eighteen of forty-one (43 per cent) patients with Sjogrens syndrome and in only two of thirty-five (6 per cent) control patients. On repeat biopsy of the lip untreated patients showed progression of lymphoid infiltration and increased immunoglobulin synthesis, whereas two patients treated with cyclophosphamide showed improvement histologically and all treated patients had diminished immunoglobulin synthesis. Sicca symptoms diminished in five of ten patients who were treated with cyclophosphamide for serious complications or other associated diseases, but immunosuppressive therapy cannot yet be recommended for uncomplicated Sjogrens syndrome.

Brain Scanning in Oligodendrogliomas

Thirty-six brain scans and biopsies from 34 patients with histologically verified oligodendrogliomas were evaluated. Twenty-nine of the 36 scans were positive (80.6%) but the abnormal uptake produced by these neoplasms had no distinguishing features. The levels of endothelial proliferation-vascularity, necrosis, and mitoses were significantly different between the positive and negative scans. In the oligodendrogliomas, the relationship between histologic malignancy, detectability on scan, and prognosis remains unresolved.

An improved detector for video systems used in radionuclide studies.

Video systems which use a comparator-type detector for quantitating radionuclide studies are characteristically insensitive at high count rates. A gated oscillator in the detector significantly reduces this nonlinearity and increases the usable dynamic range of the system.

Clinical Comparison of Two 99mTc Tracers for Brain Scanning: Pertechnetate vs. Labeled Albumin

Abstract 99mTc pertechnetate (TcO) and 99mTc, albumin (TcA) were injected at different times into 60 patients for radionuclide brain studies. Twelve out of 20 lesions were demonstrated with TcO and 15 out of 20 with TcA. There were 3 false positives with TcA. Of the 42 studies interpreted as normal with both agents, 27 were equal in quality; in 15 the TcA study was more difficult to interpret because of the confusing concentrations of the tracer in certain vascular structures. TcO remains the agent of choice for routine screening work.