Detection of antisalivary duct antibody from Sjögren's syndrome by an autoradiographic method.

A new technique to detect anti-salivary duct antibody (ASDA) has been developed by using autoradiographic, rather than immunofluorescent methods. The antibody activity detected by autoradiography is probably classic ASDA. Both techniques may be consecutively performed on the same tissue section without attenuation of either. Some of the potential advantages of the radiolabelling of ASDA are pointed out, and a few preliminary experiments using the labelled antibody as a marker are presented.

Lysozyme determination in parotid saliva from patients with Sjögren's syndrome.

Lysozyme and total protein concentrations in parotid saliva were measured in 17 patients with primary Sjögren's syndrome, in six patients with Sjögren's syndrome secondary to hyperlipoproteinemia and in 14 age- and sex-matched healthy control subjects. Increased lysozyme concentrations were found only in patients with primary Sjögren's syndrome and correlated well with the presence of parotid gland enlargement. The total protein concentration in the saliva of patients with Sjögren's syndrome was not different from that of the control subjects. Parotid saliva lysozyme determination may be useful as an early adjunctive diagnostic test of primary Sjögren's syndrome.

Changes in serum salivary isoamylases in Sjögren's Syndrome.

Quantitative polyacrylamide disk gel electrophoresis of sera from 27 patients with Sjögren's syndrome (SS) and 12 comparable normal subjects revealed that serum amylase activity in patients with SS varies due to changes in the salivary isoenzyme, while pancreatic isoamylase remains normal. The SS group can be divided into those patients with markedly increased salivary isoamylase and those with normal or low salivary isoamylase. At this time we cannot be certain whether this reflects different stages in a progressive disorder, or differences in the underlying pathologic processes. Analysis of amylase isoenzymes in serum previously has been shown to be of value in pancreatic disorders, and we have now demonstrated that changes in the salivary glands may also be relected in serum amylase isoenzymes. Study of patients with other salivary and pancreatic disorders will be needed to define the clinical utility of amylase isoenzyme analysis.

Adenoid cystic carcinoma. Analysis of fifty oral cases.

Fifty cases of oral minor salivary gland adenoid cystic carcinoma (ACC) are analyzed and reported. Oral ACC frequently masquerades as a benign neoplasm, and in the majority of cases there is no pain or ulceration. The most common location is in the palate; a plea is made for incisional biopsy of all oral lesions suspected of salivary gland origin. Survival rates show a progressive decrease with time, and there were no survivors beyond 20 years. In this study, there was a positive correlation between duration of the lesion before diagnosis and the salvage rate, but no correlation was found with the size of the presenting lesion.

Clinical applications of ultrasonic instrumentation in the surgical removal of bone.

The clinical use of ultrasonic inserts in the surgical removal of alveolar bone has been evaluated. Surgical applications included the removal of 19 teeth and the osseous management of periodontal disease in 50 cases. Histologic material was provided by resected bone fragments attached by periodontal tissues in anatomic relation to removed teeth. Microscopic observations of sections revealed that planed surfaces of bone were smooth, while incised edges were irregular. Evidence for residual debris was absent. No alterations in adjacent lacunar osteocytes, vascular channels, and underlying periodontal tissues were noted in clinical use, the ultrasonic inserts were found to remove bone with ease and preciseness. Hemorrhage from surgical sites was minimal or absent. Healing of tissues was uneventful with no postoperative complications encountered. Patients reported minimal discomfort during and following the surgical application of this instrumentation.

The healing of surgical defects in alveolar bone produced with ultrasonic instrumentation, chisel, and rotary bur.

A histologic comparison of the effects of an ultrasonic instrument, a low-speed rotary cutting bur, and a surgical chisel, all used with water coolant, on the rate of healing of dog alveolar bone was made. After reflection of a mucoperiosteal flap, each instrument was used to produce a 3 by 3 by 2 mm. defect in buccal alveolar bone, 3 mm. apical to the alveolar crest and directly overlying the root structure of the right premolar teeth. Dogs were killed immediately following flap replacement with sutures and 3, 7, 14, 28, 56, and 90 days later. Histologic examination of the surgical areas revealed that the bur produced the smoothest surface. At day 3, specimens prepared with the chisel and the ultrasonic instrument exhibited areas of cellular organization along surfaces with the defect and the formation of osteoid in adjacent marrow spaces. At day 7, osteoblastic activity was most pronounced in specimens prepared with the chisel and least in those prepared with the bur. The subsequent rate of healing in later periods appeared histologically to be the best with the use of the chisel, followed closely by the use of the ultrasonic instrument, and the slowest with the bur, the order of which is consistent with the over-all microscopic evaluation of the effect of the three instruments.

Histologic evaluation of intraoral skin grafts and pedicle flaps in humans.

Histologic evaluation of biopsy specimens from six split-thickness skin grafts and seven pedicle flaps was made two months to 15 years after intraoral cancer reconstruction. In the transplanted skin, there was persistence of all epidermal layers with production of orthokeratin and melanin, and persistence of papillary and reticular dermis with viable hair follicles and sweat glands. The junction of epidermis and mucosa was distinguished by a strongly positive PAS staining of the mucosal epithelium. There were no differences in the observations on split-thickness grafts and pedicle flaps. After 15 years of exposure to an intraoral environment, "mucosalization" of the skin was not evident.

Tangier disease with oral abnormalities.

A patient with Tangier disease, pulpal calcifications, and bilateral mandibular intrabony lesions (unusual odontomas) is presented. A relationship between Tangier disease and the oral manifestations found in this patient has not been established. Of the 27 known patients with Tangier disease, only 2 have been examined.

Correlative histologic and serologic findings of sicca syndrome in patients with systemic lupus erythematosus.

We prospectively evaluated 24 patients with systemic lupus erythematosus for clinical, histologic, and serologic evidence of sicca syndrome. Abnormalties suggestive of sicca syndrome in patients with systemic lupus were identified by parotid scan (58%), questionnaire (54%), labial biopsy (50%), Schirmer's test (21%), and parotid flow rate (13%). An increased frequency of autoantibodies to gamma globulin and cellular antigen SS-A was detected in lupus patients with histologic changes on labial biopsy. The serologic findings are similar to those of patients with sicca syndrome alone with the exception of the reduced incidence of anti-SS-B in patients with systemic lupus.