Biomedical subjects
Publications and source records attributed to W Mann.
In chronic sinusitis allergy is one important factor for the pathogenesis of the disease. Various others, such as genetically determined or acquired ciliary disorders have to be ruled out. In allergic rhinosinusitis, allergy treatment improves postoperative results considerably.
Dimethylsulfoxide (DMSO) up to 25% (v/v) does not cause irreversible alterations of T3 DNA at 42.5 degrees C as assayed by transcription with T3-specific RNA polymerase. The optimal temperature for the formation of polyanion-resistant ternary complexes of the enzyme, T3 DNA, and nascent RNA chains is lowered by 12.5 degrees C in the presence of 20% (v/v) DMSO. The same solvent concentration, however, decreased the temperature optimal for T3 RNA chain elongation by only 2.5 degrees C, indicating that DMSO preferably affects the initiation of T3 RNA synthesis. DMSO accelerates the loss of T3-specific RNA polymerase activity at 24.5 degrees C. Nevertheless, the speed with which the binary complexes between the phage RNA polymerase and DNA are inactivated by heat (42.5 degrees C) is not altered in presence of 20% (v/v) DMSO. The binding of T3-induced RNA polymerase to T3 DNA in polyanion-resistant ternary complexes is influenced by DMSO which makes the enzyme accessible to the inhibitory action of polyvinyl sulfate. Elongation of T3 RNA chains is slowed down by 20% (v/v) DMSO.
In a histochemical and ultrastructural study the pathogenesis of cholesteatoma ostitis is analysed on human tissue. In the subepithelial layer there is evidence of an inflammatory reaction leading to proliferation of granulation tissue with bony invasion. Bony destruction is initiated by osteocytic osteolysis. In the case of cholesteatoma there is a combined action of extraosseous and osseous lysosomal enzymes. The pathological changes of the fibrillar elements suggest that the self-perpetuation of degeneration is maintained by a disturbance of fibrillogenesis. The causal pathogenesis of cholesteatoma formation is discussed as a function of a disturbance between cellular activity, extracellular matrix, and cellular surface.
A dose-ranging pharmacokinetic study of buflomedil was carried out in eight subjects to determine the pharmacokinetic parameters of the drug after oral and intravenous administration. Based on AUC infinity analyses, the pharmacokinetics of buflomedil were found to be linear within the dose ranges studied (50 to 200 mg for i. v. injection and 150 to 450 mg for oral administration). In the oral study, the mean biological half-life of the drug was 2.97 h, while after intravenous dose it was 3.25 h. The apparent volume of distribution after the pseudodistribution equilibrium (Fd beta) and volume of distribution at the steady state (Vdss) were 1.43 +/- 0.24 l/kg and 1.32 +/- 0.26 l/kg, respectively. The mean urinary recovery of intact drug and the metabolite, paradesmethyl buflomedil, after intravenous dosing, were 23.6% and 18.7%, respectively, while after oral dosing, they were 18% and 14.8%, respectively. On the average, 72% of the dose was observed into the systemic circulation after oral administration. This level of bioavailability was attributed to the hepatic first-pass effect.
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Studies have shown, that the normal flora of the upper airway harbors many different anaerobic bacteria. They play an important role in many chronic diseases such as chronic sinusitis, chronic secretory otitis and chronic tonsillitis. On the other hand they may cause acute situations such as pharyngeal abscess, Ludwig's angina, Vincent's angina or space infections in the neck. The bacteria most frequently reported from infected sites are Bacteroides sp., anaerobic cocci and fuso-bacteria. Bacteroides fragilis plays a minor role. Anaerobic pathogens should also be considered in patients with major surgery of the head and neck following radiation therapy. This concept leads to a considerable reduction of major and minor surgical complications.
The connective tissue contains extracellular enzymes for the turnover of the ground substance. If this enzyme system gets out of control there is development of a complex metabolic disturbance of all tissue components. The lysosomal dysfunction is the basis of the general mechanism of tissue destruction in cholesteatoma, oto- and tympanosclerosis. This process seems most enhanced in cholesteatoma. Emphasis is placed on the role of extracellular lysosomes (= matrix vesicles).
A clinical trial, in which the spontaneous self-cure rate of acute, chronic and childhood sinusitis was studied, is reported. The spontaneous cure rate in acute sinusitis, using analgesics only, range up to 79 per cent within 14 days. In chronic maxillary sinusitis using placebo treatment only, the pathological findings settled in 60.9 per cent within 21 days. A 5 year study of sinusitis in children aged 7-13 years showed a spontaneous self-cure rate of 94 per cent. These findings encourage a conservative approach in the management of sinusitis.
The syndrome ectodermal dysplasia is approached especially from the ENT-specialist's point of view. One case of this rare syndrome is reported and discussed.
A case of adenocarcinoma in the maxilloethmoidal angle is reported. Progressive loss of differentiation following radiation and surgery was observed during the course of the disease. Professional etiology is discussed, the patient being woodworker for 18 years.
In a combined lymphangioscopical and ultrastructural examination 7 months post telecobalt 60 irradiation with 60 Gy, the morphological and functional aspects of the inner laryngeal lymph capillaries were studied. The prominent feature of the morphological changes was the endothelial damage of the lymphatic capillaries including swelling, vacuolisation and necrosis. Many lymph vessels were dilated but patent. A few capillaries where collapsed and surrounded by increased amounts of fibrous tissue, some capillaries where lacking their endothelial lining. So degeneration of the endothelial cell i.e. of the endothelial junctions and focal increase of interstitial collagen with resulting stenosis of the capillaries may be observed. The clinical and functional aspects of the morphological findings are discussed.
Diagnostic A- and B-mode ultrasonography is used for detection of paranasal sinus disease. Various cases of maxillary, frontal and ethmoidal sinus pathology demonstrate the indication and limitations for this new method. Differential diagnostic of an opacified antrum is possible changing gain control and patients head position during examination.
The intranasal test was made on 100 patients with possible allergy to house dust, house dust mite and fungi. The results of 64 patients could be discussed. Till now a nasal obstruction with arhinomanometric flow-volume diminution of 20% after application of allergene was considered as a positive provocation. This procedure seems to give too many false positive results. A new method to evaluate the rhinoma nometric results was elaborated.
Between 1967 and 1980 laryngeal leukoplakia was clinically diagnosed in 86 patients. Histology revealed a true invasive carcinoma in 18 patients. Epithelial dysplasia grade I was found in 32 patients, grade II in 25 and grade III (carcinoma in situ) in 9 patients. 8 patients (14%) with dysplasia grade I and II subsequently developed carcinoma in situ or true invasive carcinoma. The average time lapse between first biopsy and histologically verified carcinogenesis was 5.1 years. No correlations was found to the histological grading.
In a histochemical and electron microscopical study the pathogenesis of otosclerosis was investigated. The morphological changes in the extra- and intracellular space indicated a complex metabolic disturbance of all tissue components. The observed chondrocytic chondrolysis stressed the role of the cartilage remnants in the otic capsule as an etiological factor. There was morphological evidence of a superimposed enzymatic defect.
Intrraluminal manometric investigations in the hypopharynx and sphincter area post laryngectomy revealed pressure recordings of 54 mm Hg and 33 mm Hg, respectively, during the act of swallowing. Aspiration of saliva or food after a laryngectomy with a hypopharyngeal-tracheal shunt can be explained on these grounds.
Residue occurrence is discussed with use of 14 herbicides (Alachlor, Chloridazone, Chlorpropham, Chloroxuron, Chlorthal-methyl, Desmetryne, Lenacil, Linuron, Methabenzthiazuron, Monolinuron, Na-propamide, Pendimethalin, Phenmedipham and Terbutryne) on 6 herbs (borage, dill, garden-chervil, garden cress, anise and sorrel) in the light of residue analyses (from field trials over two seasons with analyses carried out in two laboratories). The methods are outlined; limits of the determinations and recoveries are given.
Water samples which were obtained from 21 ENT examining units were studied for the presence of bacteria. 10(4)--10(6) colony forming bacteria per ml were found in 13 of the units, while an additional 10(2)--10(4) organisms/ml were found in 8 units. Pseudomonas species were found in all samples and primarily involved Ps. acidovorans and Ps. paucimobilis.