Biomedical subjects
Publications and source records attributed to W Mann.
The influence of growth on tubal function was studied in 26 children by means of tubal function tests in a pressure chamber and by geometric analysis of lateral cephalograms. Good tubal function coincided with mesoor brachycephalic skeletons, poor tubal function with dolichocephalic morphologic patterns. According to our results, tubal function seems to be strongly influenced by the growth processes of the skull.
In a histological and electron microscopical study the authors investigated the pathogenesis of tympanosclerosis. Emphasis was placed on the role of extracellular lysosomes (= matrix lysosomes). The function of such matrix lysosomes is connected with the two-stage degradation of the connective tissue. This system gets out of control in tympanosclerosis. Inflammatory and immunological processes are suggested to be superimposed on this lysosomal action.
Lymphangioscopical and ultrastructural studies of the larynx reveal a lymphatic capillary and a collecting vessel system. Collecting vessels show luminal valves and elastic structural components within the wall. Lymphangioscopy reveals that a strict compartmentation of different laryngeal areas is unjustifiable with the exception made for the capillaries of the free margin of the true vocal cords. Multiple anastomoses of capillaries and collecting vessels enhance midline- and vertical plane-crossing lymphatic drainage. These collaterals are gaining importance in case of impediment of the physiologic drainage pathway.
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We have developed a sensitive and specific sandwich-type enzyme-linked immunosorbent assay to detect M(r) 72,000 type IV collagenase [matrix metalloproteinase 2 (MMP-2)] in human plasma. As a result of the linkage between MMP-2 production by cancer cells and the metastatic phenotype, we undertook this study to compare plasma MMP-2 levels in healthy individuals, patients with various types of cancer, and hospitalized patients with chronic diseases other than cancer. The results demonstrate that MMP-2 levels are not increased in cancer patients regardless of the extent of disseminated malignancy. In an effort to explain this data, we compared MMP-2 secretion by human umbilical vein endothelial cells and lung cancer cells passaged as cell lines. Endothelial cells secreted higher levels of MMP-2 than did lung cancer cells propagated in vitro. We propose that blood vessel lining cells make a sizable contribution to plasma levels of MMP-2 and may thereby obfuscate the detection of increased levels of MMP-2 originating from extravascular sources such as solid tumors.
Several recent studies have labelled the anterior ethmoid as the main source of chronic and/or recurrent sinusitis in the entire paranasal sinus system. In an attempt to identify other possible patterns of developing sinusitis, 1,345 computed tomographies of neurological and neurosurgical patients with no previous history of paranasal sinusitis were evaluated. These scans were made between 1985 and 1989 in the Neurosurgical Clinic of the University of Freiburg. Seventy-five of these studies revealed evidence of inflammatory changes. In 57 scans maxillary sinus disease was evident, while in 46 there was en ethmoid disease, in 24 a sphenoid sinus disease and in 17 a frontal sinus disease. Nine scans showed pansinusitis. In 24 studies, one sinus location was involved (uni- or bilaterally) and among these were 21 with maxillary, 2 with anterior ethmoidal and 1 with frontal sinus involvement. In 38.7% of the examined scans, the anterior ethmoidal complex was free of disease. This study shows that, at least radiographically, the ethmoidal infundibulum is not always the origin of paranasal sinus disease. An isolated frontal, maxillary or sphenoidal sinusitis can develop as well. These results show that a simple anterior ethmoidectomy cannot be considered the panacea for chronic and/or recurring sinusitis. Surgical therapy of inflammatory sinus disease should, on the contrary, be tailored to each patient depending on anamnesis, clinical findings and CT results.
The peritoneal washing cytologies of 109 patients (112 procedures) undergoing laparotomy for cervical carcinoma were evaluated retrospectively and compared with the clinical and pathologic findings. Nine patients (8.3%) had malignant peritoneal washings (including three of four with washings initially termed "inconclusive"). Four (4.9%) of the 82 patients with squamous carcinoma and 3 (16.7%) of 18 with adenocarcinoma had positive washings. Five (5.6%) of 90 washings obtained at initial explorations were positive, as compared with 4 (18.2%) of 22 washings obtained as follow-up operations in recurrent cases. The 111 peritoneal washing cytologies with a corresponding histologic evaluation of the peritoneal cavity showed a good correlation; peritoneal washing cytology had an efficiency of 91.0%, a sensitivity of 52.9% and a specificity of 100%. Two cases in which the cytologies were considered positive only after review had negative peritoneal histologies; both patients died of progressive disease within 11 months. Peritoneal washing cytology was positive in 5 (5.9%) of 84 cases with FIGO stage 1 cancers, 2 (18.2%) of 11 cases with stage 2 cancers, 1 (33.3%) of 3 cases with stage 3 cancers, and 1 (10%) of 10 cases with recurrent tumors. Eight (88.9%) of nine patients with malignant peritoneal washings died of disease from 3 to 15 months following surgery; one showed no evidence of disease at 9 months. These results suggest that: (1) cervical carcinomas are infrequently associated with a positive peritoneal washing; (2) peritoneal washing cytology is more likely to be positive in cases of adenocarcinoma than in cases of squamous carcinoma; (3) peritoneal washings obtained at the time of surgery for recurrence are more likely to contain malignant cells than are washings obtained during initial exploration; (4) nonkeratinizing malignant squamous cells may be confused with reactive mesothelial cells; and (5) peritoneal washing cytology is a relatively insensitive technique for detecting advanced cervical disease, but correlates with a poor prognosis when positive.