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Biomedical subjects

B Tillmann

Publications and source records attributed to B Tillmann.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Anatomical comment: Hohmann retractor. A source of danger to the sciatic nerve.].

In referring to the article by Stühmer the authors describe the topographic relationship between the sciatic nerve and an inserted normal Hohmann retractor or a specially designed retractor by Stühmer. By simulating the surgical circumstances the following observations are made:In lateral position and with external rotation of the hip the sciatic nerve is found directly posterior to the major trochanter. When inserting the Hohmann retractor its point slips between the trochanter and the sciatic nerve. The nerve lies directly on the retractor or can be injured by inserting it. Contrary to this the Stühmer retractor avoids pressure on or skewing of the nerve.

English Abstract↗
PubMed1996

[Changes in extracellular matrix in the lamina cribosa of patients with secondary glaucoma].

The aim of this study was to analyze the localization and distribution of extracellular matrix in normal and glaucomatous damaged optic discs using immunohistochemical methods. Five eyes donated for corneal allografting without any history of glaucoma and three other eyes with secondary glaucoma were studied. Immunohistochemical reactions were performed with antibodies against collagen types I, III, IV and VI and against laminin, proliferating antigen KI67 and GFAP. In glaucomatous eyes the characteristic arrangement of collagen fibrils is lacking. Septa of the lamina cribrosa appear enlarged. The immunoreactivity of all examined collagen types is stronger in glaucomatous eyes. The axon basement membranes show an irregular and interrupted pattern. The number of proliferating cells with positive GFAP staining in glaucomatous cribriform plates is distinctly higher. We postulate that fibroblasts and astrocytes in the stroma of glaucomatous lamina cribrosa could be stimulated to increased and uncontrolled proliferation. Associated disorganization and raised secretion of extracellular matrix may lead to axon constriction and, secondarily, to neural degeneration.

Adult↗
PubMed1996

[Structure and function of the ventral vocal cord insertion. From the clinical viewpoint].

BACKGROUND: Spread of cancer at the ventral vocal fold insertion zone has been discussed controversially until today. One reason for this is the so far insufficient knowledge of the anatomical structure and function of the insertion zone. METHODS: The present study analyses the structures of laryngeal anterior commissure by means of histological, immunohistochemical and electron microscopical methods. Investigations are performed on vocal cords of 17 male and 13 female (aged 21-88 years) in three planes. RESULTS: The vocal ligament inserts at the anterior commissure via two characteristic structures: the noduli elastici, which consist of two different morphological zones, and the vocal ligament tendon, a dense mesh of connective tissue rich in sulfated glycosaminoglycans. In the lower part of noduli elastici collagen and elastic fibres form a meshwork around embedded cells; in the upper part fibres are running in parallel. The vocal ligament tendon is connected to the thyroidal cartilage or bone by fibrocartilage. This area lacks a perichondrium or periosteum. At the beginning of osteogenesis vessels of plica vocals penetrate the bony thyroidal skeleton and contact with extralaryngeal vessels. CONCLUSIONS: Connective tissue cells of the insertion zone and extracellular matrix components formed by these cells fulfil biomechanical functions by equalizing the different elastic moduli of tendon, cartilage or bone. Ventral spread of vocal fold carcinomas is made possible by the lack of periosteum in the insertion zone as well as ossification and associated vascularisation of the thyroid cartilage.

Adult↗
PubMed1996

Scanning electron-microscopic studies of the collagen architecture of the human sclera--normal and pathological findings.

The arrangement of the collagen fibrils of the human sclera was analyzed in the region of the limbus cornea, the corneoscleral trabeculum, at the zone of muscle insertion and at defined areas of the internal and external surface of the sclera. Adult eyes with no apparent pathological alterations and the sclera of a patient with staphyloma were examined by scanning electron microscopy. The investigations were performed to describe regularities in the collagen architecture in normal and pathologically altered eyes to understand pathomorphologic and pathophysiologic changes in scleral diseases.

Aged↗
PubMed1996

SEM studies of the collagen architecture of the human lamina cribrosa: normal and pathological findings.

The arrangement of the collagen fibrils of the lamina cribrosa was analyzed by using scanning electron microscopy with clinical regard to morphological alterations in cases of glaucoma at different stages. Adult eyes with no apparent pathological changes and specimens from patients with absolute glaucoma were studied. In the lamina cribrosa of nonpathological eyes the collagen fibrils are arranged circularly around the points of passage of axons and vessels. In specimens from glaucoma patients the characteristic circular alignment of the collagen fibrils around the penetrating axons is generally absent. The collagen fibrils are arranged in coarse bundles, showing no preferred alignment. The present study supports a new hypothesis for glaucoma pathogenesis.

Aged↗
PubMed1995

Morphological studies on the pathogenesis of Reinke's edema.

Light microscopy of vocal cord mucosa in patients with Reinke's edema revealed highly ramified fissured spaces in the subepithelial tissue that were generally lined with flat cells. The ultrastructure of the parietal cells resembled fibroblasts whose cytoplasmic extensions overlapped in two to three layers in some places. Cell contacts were not observed. Neither electron microscopy nor immunohistochemical testing with antibody against laminin demonstrated a basal membrane. It was possible to distinguish between light and dark cells in the specimens examined. The cytoplasm of the light cells contained intermediate filaments, mitochondria, lysosomes, coated vesicles, caveolae and broad cisternae of rough endoplasmic reticulum. The dark cells were more numerous and typically exhibited a well-developed endoplasmic reticulum and free ribosomes. The parietal cells showed no immunoreaction against human vascular endothelial cells. Immunohistochemical demonstration of mesenchymal intermediate filaments using antibody against vimentin yielded a positive reaction for some of the cells in the walls of the crevices and subepithelial tissue. It was also possible to demonstrate a few cells with monoclonal antibody against macrophages (KiM6). These findings contradict the concept of lymphatic distension in cases of Reinke's edema. Since the parietal cells seen resembled synoviocytes in their structure and immunohistochemical reactions, findings indicate that the hollow spaces of Reinke's edema develop like neobursae from mechanical strain.

Adult↗
PubMed1995

The distal tendon of the biceps brachii. Structure and clinical correlations.

The structure and blood supply of 42 distal biceps tendons were investigated by means of light and electron microscopy as well as by immunohistochemistry. Possible structural causes for the rupture of the tendon are discussed. The distal biceps tendon wraps around the radius during pronation of the forearm. In this area the tendon is exposed to pressure and shearing forces in addition to those caused by tension. Two fibrocartilaginous areas were regularly observed. Large chondrocyte-like cells were found inside the fibrocartilage. As an expression of strain, the extracellular matrix is rich in acidic glycosaminoglycans and stains intensely with toluidine blue at pH 1. Electron microscopy showed a granular pericellular matrix that increases in size towards the gliding surface. Type I collagen is the main component of the distal biceps tendon. Type II collagen is found in tendon fibrocartilage but not in traction tendons. The gliding surface of the tendon is made up of reticular fibres that are equivalent to type III collagen. Monoclonal antibodies revealed the presence of dermatan-sulfate, keratansulfate and chondroitin-4- as well as chondroitin-6-sulfate. Blood vessels are usually absent in fibrocartilage, as was shown with a polyclonal antibody against the basement membrane component laminine. There are significant differences between the extracellular matrix of traction and gliding tendons, which may be responsible for the location of tendon rupture.

Adolescent↗
PubMed1995

[Functional adaptation processes of gliding tendons].

Structure and blood supply of the inserting tendons of supraspinatus and biceps brachii as well as the biceps brachii long head tendon are analyzed in respect of tendon rupture. Due to their course the three tendons investigated are gliding tendons. The part of the tendon adjacent to the pulley consists of fibrocartilage, the part looking away from the pulley having the structure of a traction tendon. The occurrence of fibrocartilage inside the investigated tendons is physiological and not a pathological finding. Development of fibrocartilage is a functional adaptation to pressure and shearing forces acting on the tendon at the pulley. In the investigated samples injection techniques and immunohistochemical methods show an avascular area in the part of the tendon that is adjacent to the pulley. The size of this area is identical with the fibrocartilage. The avascular zone in gliding tendons is due to structure, fibrocartilage is usually avascular. Localisation of rupture and fibrocartilage is nearly identical in the investigated tendons. Unphysiologically increased tensile stress which is inadequate for gliding tendons and occurs in certain kinds of sport may be responsible for the development of ruptures of the tendons of supraspinatus and biceps brachii.

Adaptation, Physiological↗
PubMed1995

Age-related blood and lymph supply of the knee menisci. A cadaver study.

We investigated 20 human menisci (22 weeks of gestation-80 years) immunohistochemically with an antibody against laminine in the basement membrane. Differentiation of blood vessels and lymphatics was possible with histochemical proof of alkaline phosphatase and 5' nucleotidase in the endothelium. Blood vessels entered the menisci from the joint capsule accompanied by loose connective tissue. In the 22nd gestational week, vessels could only be found in the lateral third. At the time of birth, nearly the whole meniscus was vascularized. In the second year of life, an avascular area developed inside the inner circumference. In the second decennium, blood vessels occurred only in the lateral third. After 50 years of age, only the lateral quarter of the meniscal base was vascularized. The dense connective tissue of the insertion was vascularized, but not the fibrocartilage of the insertion. Blood vessels were accompanied by lymphatics in all areas.

5'-Nucleotidase↗
PubMed1995

[The "dangerous loop" of the internal carotid artery. An anatomic study].

Variations of the clinical course of the internal carotid artery in the parapharyngeal space were studied in order to define possible causes of acute hemorrhage during pharyngeal surgery. Four cases of sigmoid tortuosity involving the internal carotid artery were found in a total of 81 dissected carotid sheathes and 8 corrosion casts. In 2 cases the internal carotid artery was located in direct contact with the tonsillar fossa to form a clinically unsafe carotid tortuosity that was considered at risk during tonsil surgery.

Aged↗
PubMed1995

[The laryngeal lymph vessel system of the human. A morphologic and lymphography study with clinical viewpoints].

Laryngeal carcinomas have different metastatic characteristics depending on their locations. Although these changes could be explained by differences in density of the lymphatic system, studies of the laryngeal lymphatic system have been controversial. To clarify these differences the lymphatic systems of 184 organ specimens were investigated with light and electron microscopy, histochemistry and injection techniques. Three types of lymphatic vessels were found in the larynx: lymph sinuses, precollectors and collectors. The highest density of lymphatics was found in the supraglottic larynx. From this region, lymph drained via 3-6 collectors to a hypopharyngeal collector. The subglottic lymph mainly drained via 2-4 collectors to paratracheal and mediastinal lymph nodes. The lymph system of the vocal folds was sparse but drained mainly to the supraglottic larynx. No lymph collector was found in the mucosa of the vocal fold. According to these results, the incidence of lymphatic spread correlated first with the density of the initial lymphatics in the various laryngeal regions and secondly (and probably of greater significance) with nearness of tumor to the laryngeal collectors.

Endothelium, Lymphatic↗
PubMed1994

The structure and vascularization of the biceps brachii long head tendon.

In the present study we examined the structure and the blood supply of the long biceps tendon as well as the surface of the intertubercular sulcus, using tissue samples from children and adults. The applied methods were light and electron microscopy, immunohistochemistry, and arterial injection techniques. The tendon represents a sliding tendon with the intertubercular sulcus and humeral head as hypomochlion. The parts facing the humerus show some ultrastructural features of fibrous cartilage, the ovoid chondrocyte-like cells of the tendon lying within felt-like matrix. In the opposite part adjacent to the capsule, the tendon resembles a traction tendon. The intertubercular sulcus is covered by fibrous cartilage. The tendon is supplied with arteries from three different sources. The density of intratendinous vessels in the traction zone is comparable to that of other tendons, while in the sliding zone it is markably decreased. The immediate vicinity of the sliding surface is avascular. Our findings show that the long biceps tendon is structurally adapted to both its functions as sliding and traction tendon. The blood supply seems to be related to the metabolic requirements of the different parts of the tendon.

Adolescent↗
PubMed1994

[Structures of the anterior commissure of the larynx. Biomechanical and clinical aspects].

The vocal ligaments and vocalis muscles insert at the anterior commissure of the thyroid cartilage. The biomechanical function of the connective tissue of the insertion is to equalise the different elastic modules of tendons and cartilage or bone. Structures of the insertion of plica vocalis at the anterior commissure are clinically important considering the spread of carcinoma that can grow along the vocal ligament in a ventral direction. The lack of perichondrium or periosteum in the area of insertion, ossification of the thyroid cartilage and the associated vascularisation of the skeleton allow the invasion of tumours in the thyroidal skeleton.

Adolescent↗
PubMed1993

The collagen architecture of the sclera--SEM and immunohistochemical studies.

The arrangement of the collagen fibrils of the sclera was analyzed at defined areas by using SEM with regard to morphological alterations in cases of glaucoma and to postoperative astigmatism after cataract operations. Adult eyes with no apparent pathological changes were studied. In the lamina cribrosa the collagen fibrils are arranged circularly around the points of passage of the axons and vessels. In the region of the muscle attachments the tendinous collagen fibrils intersect the bundles of collagen fibrils of the sclera at right angles. The collagen fibrils form a reticular structure on the external surface of the sclera. A main route of alignment can only be identified in a few places. The collagen fibrils are aligned in a rhombic pattern on the internal surface of the sclera. The immunohistochemical analysis revealed collagen types I and III in the sclera, while collagen types I, III and IV were found in the lamina cribrosa.

Aged↗
PubMed1993

Detection of lymph and blood vessels in the human intervertebral disc by histochemical and immunohistochemical methods.

Twenty-four intervertebral discs from the lumbar region of postmortem human subjects were investigated by immunohistochemical and histochemical methods to evaluate the pattern of blood and lymph vessels of the discus intervertebralis and surrounding tissue at different ages. Antibodies against the basement membrane component laminin, and the lectin Ulex europaeus agglutinin as a marker for L-fucose in endothelial cells, were used to make the blood vessels visible. The 5'-nucleotidase activity in lymph endothelium served as a marker for lymphatic vessels. The dorsolateral parts of the connective tissue adjacent to the discus intervertebralis were well vascularized in all age groups examined. Vessels in the outer anulus fibrosus were detected in young individuals up to 20 years of age. Vascular canals, i.e. blood vessels in the cartilage end plate, were seen up to 7 years of age. Lymph capillaries are first described here penetrating the disc and peridiscal tissue and accompanying most of the small blood vessels into the areas specified.

5'-Nucleotidase↗