This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Cigarette smoking is reported in about one third of adults worldwide. A strong relationship betwe... more Cigarette smoking is reported in about one third of adults worldwide. A strong relationship between cigarette smoke exposure and chronic obstructive pulmonary disease (COPD) as well as lung cancer has been proven. However, about 15% of lung cancer cases, and between one fourth and one third of COPD cases, occur in never-smokers. The effects of cigarette smoke on the innate as well as the adaptive immune system have been widely investigated. It is assumed that certain immunologic features contribute to lung cancer and COPD development in the absence of smoking as the major risk factor. In this article, we review different immunological aspects of lung cancer and COPD with a special focus on non-smoking related risk factors.
SummaryWe present a case of bilateral cystic lung metastases originating from cutaneous angiosarc... more SummaryWe present a case of bilateral cystic lung metastases originating from cutaneous angiosarcoma (cAS) of the scalp in a 73-year-old man. He presented with hemoptysis and recurrent bilateral pneumothorax. The clinical, radiological, and histological features and a potential pathophysiological mechanism of pulmonary changes in cutaneous angiosarcoma are discussed.
Autophagy is an important cellular repair mechanism, aiming at sequestering misfolded and dysfunc... more Autophagy is an important cellular repair mechanism, aiming at sequestering misfolded and dysfunctional proteins and damaged cell organelles. Dysfunctions in the autophagy process have been linked to several diseases, like infectious and neurodegenerative diseases, type II diabetes mellitus and cancer. Living organisms are constantly subjected to some degree of oxidative stress, mainly induced by reactive oxygen and nitrogen species. It has been shown that autophagy is readily induced by reactive oxygen species (ROS) upon nutrient deprivation. In recent years, research has increasingly focused on outlining novel therapeutic targets related to the autophagy process. With this review of the literature, we want to give an overview about the link between autophagy, oxidative stress and carcinogenesis.
Summary Background In the last two decades, both treatment options and epidemiological features o... more Summary Background In the last two decades, both treatment options and epidemiological features of cancer have changed. We studied the influence of related parameters on the outcome of patients undergoing resection for esophageal carcinoma. Methods We analyzed 499 consecutive patients who underwent esophagectomy for carcinoma since January 2000, comparing 2000–2010 with 2011–2021 and examining changes over time. Results The percentage of men (87.9 vs. 86.9%; p = 0.74) in the two groups was unchanged, whereas mean age increased significantly from 60.8 to 65.2 years (p = 0.000). There was a trend towards an increase of adenocarcinoma (gamma = 0.120, ASE = 0.055). Despite significantly increasing use of induction chemoradiotherapy (p = 0.000) from 7.14% in 2000 to 68.9% in 2021 the distribution of pT, pN stage, grading and the rate of positive lateral resection margins remained unchanged. When comparing the two periods, the overall 30-day mortality was 4.4 vs. 4.2% (p = 0.56), recurren...
Summary Background In the last two decades, both treatment options and epidemiological features o... more Summary Background In the last two decades, both treatment options and epidemiological features of cancer have changed. We studied the influence of related parameters on the outcome of patients undergoing resection for esophageal carcinoma. Methods We analyzed 499 consecutive patients who underwent esophagectomy for carcinoma since January 2000, comparing 2000–2010 with 2011–2021 and examining changes over time. Results The percentage of men (87.9 vs. 86.9%; p = 0.74) in the two groups was unchanged, whereas mean age increased significantly from 60.8 to 65.2 years (p = 0.000). There was a trend towards an increase of adenocarcinoma (gamma = 0.120, ASE = 0.055). Despite significantly increasing use of induction chemoradiotherapy (p = 0.000) from 7.14% in 2000 to 68.9% in 2021 the distribution of pT, pN stage, grading and the rate of positive lateral resection margins remained unchanged. When comparing the two periods, the overall 30-day mortality was 4.4 vs. 4.2% (p = 0.56), recurren...
[SARS-CoV-2-associated pneumothorax, pneumomediastinum and soft tissue emphysema. Clinical implications based on a case series]
The new coronavirus (SARS-CoV-2) that arose in 2019 causes a wide spectrum of symptoms and differ... more The new coronavirus (SARS-CoV-2) that arose in 2019 causes a wide spectrum of symptoms and different courses of disease. Pneumothorax, pneumomediastinum and soft tissue emphysema are rare complications in patients with pulmonary involvement. They are the sequelae of severe, virus-induced structural changes of the pulmonary architecture. High pressure artificial ventilation aggravates the problem. Hence pneumothorax and ectopic air in soft tissues are indicators of extensive pulmonary damage. Therefore, efforts should be made to treat even very small or multiply recurrent pneumothorax by drainage procedures.
Background: Pulmonary metastasectomy (PM) has commonly been performed in patients with controlled... more Background: Pulmonary metastasectomy (PM) has commonly been performed in patients with controlled metastatic sarcoma. We reviewed our single-institution experience with pulmonary resections for sarcoma to analyse clinical outcome and to identify prognostic factors associated with patient survival. Methods: All sarcoma patients undergoing curative intent PM between 2008 and 2014 were retrospectively analysed. Factors related to primary tumour, metastases, applied therapy, systematic inflammation and preoperative nutritional condition, associated with survival after PM were evaluated using the univariable Cox proportional hazard model. Cutoff values of continuous variables were determined by a receiver operating characteristic (ROC) analysis. Results: In total, 33 patients (19 male and 14 female, median age 55 years) underwent PM for metastatic sarcoma. There were no perioperative deaths; major complications occurred in 5 (15.2%) patients. The median interval between the treatment of primary tumour and PM was 16 months (range, 0-171 months). The median size of the largest pulmonary lesion was 1.3 cm. Mean follow-up was 37 months (range, 1-100 months) and the 5-year overall survival (OS) rate after first PM was 40.4%. Resection was complete (R0) in 31 (93.9%) patients. In univariable analysis, a shorter interoperative interval [<30 months, hazard ratio (HR) 5.05, 95% confidence interval (CI): 1.15-22.19] and grade 3 (G3) sarcoma (HR 3.52, 95% CI: 1.01-12.25) were significant negative prognosticators. Conclusions: Despite the lack of randomized controlled trials PM for sarcomatous disease is a reasonable therapeutic option with acceptable survival in a selected patient population. In sarcoma patients with a shorter interoperative interval and G3 tumour, shorter survival after PM can be expected.
Videothorakoskopisches Sympathikus-Clipping bei einem Patienten mit Lobus venae azygos. Intraoperatives Management zur Vermeidung von potenziellen Komplikationen
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie
Zusammenfassung Einführung Sympathikus-Clipping bei vorliegendem Lobus venae azygos ist eine selt... more Zusammenfassung Einführung Sympathikus-Clipping bei vorliegendem Lobus venae azygos ist eine seltene Kombination. Aufgrund der engen anatomischen Beziehung zwischen dem Truncus sympathicus und dem Mesoazygosnetz kann das chirurgische Handling erschwert und mit potenziellen Komplikationen assoziiert sein. Indikation In unserem Fall handelt es sich um eine 25-jährige Patientin mit einer therapierefraktären palmoplantaren und axillären Hyperhidrosesymptomatik Schweregrad III und einem als Zufallsbefund präoperativ röntgenologisch diagnostizierten Lobus venae azygos. Methode Unser intraoperatives Video zeigt ein schrittweises Vorgehen bei Vorliegen eines Lobus venae azygos kombiniert mit einem endoskopischen Anschlingen und einer präzisen Clip-Applikation am Truncus sympathicus sowie die videoassistierte Reposition mit vollständiger Expansion des akzessorischen Lungenlappens zur Vermeidung von potenziellen Komplikationen. Fazit Das videothorakoskopische Sympathikus-Clipping ist bei Pati...
Bedeutung der selektiven Lebensqualitätsanalyse nach Sympathikus-Clipping bei Patienten mit lokaler Hyperhidrose
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie
Zusammenfassung Einleitung Die Hyperhidrose (HH) geht mit einer physischen und psychischen Einsch... more Zusammenfassung Einleitung Die Hyperhidrose (HH) geht mit einer physischen und psychischen Einschränkung einher. Die Behandlung umfasst sowohl konservative als auch operative Methoden und strebt eine dauerhafte Verbesserung der Lebensqualität (LQ) der Betroffenen an. Die endoskopische Sympathikusblockade (ESB) stellt eine etablierte operative Therapiemethode dar und gilt als ein effektives chirurgisches Verfahren bei Versagen der konservativen Therapieoptionen. Das Ziel unserer Studie war, die LQ-Veränderung und die Patientenzufriedenheit nach ESB durch umfangreiche Analyseverfahren zu untersuchen und entsprechende Einflussfaktoren zu identifizieren. Methoden Von Juli 2008 bis April 2016 wurden 105 Patienten wegen therapierefraktärer HH operiert. In allen Fällen wurde ein ESB entsprechend vorliegenden Hyperhidroseform und dem STS-Expertenkonsens (STS: Society of Thoracic Surgeons) durchgeführt. Die LQ und das Hyperhidrosestatus wurden anhand von detaillierten Fragebogen (ein selbst ...
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Cigarette smoking is reported in about one third of adults worldwide. A strong relationship betwe... more Cigarette smoking is reported in about one third of adults worldwide. A strong relationship between cigarette smoke exposure and chronic obstructive pulmonary disease (COPD) as well as lung cancer has been proven. However, about 15% of lung cancer cases, and between one fourth and one third of COPD cases, occur in never-smokers. The effects of cigarette smoke on the innate as well as the adaptive immune system have been widely investigated. It is assumed that certain immunologic features contribute to lung cancer and COPD development in the absence of smoking as the major risk factor. In this article, we review different immunological aspects of lung cancer and COPD with a special focus on non-smoking related risk factors.
SummaryWe present a case of bilateral cystic lung metastases originating from cutaneous angiosarc... more SummaryWe present a case of bilateral cystic lung metastases originating from cutaneous angiosarcoma (cAS) of the scalp in a 73-year-old man. He presented with hemoptysis and recurrent bilateral pneumothorax. The clinical, radiological, and histological features and a potential pathophysiological mechanism of pulmonary changes in cutaneous angiosarcoma are discussed.
Autophagy is an important cellular repair mechanism, aiming at sequestering misfolded and dysfunc... more Autophagy is an important cellular repair mechanism, aiming at sequestering misfolded and dysfunctional proteins and damaged cell organelles. Dysfunctions in the autophagy process have been linked to several diseases, like infectious and neurodegenerative diseases, type II diabetes mellitus and cancer. Living organisms are constantly subjected to some degree of oxidative stress, mainly induced by reactive oxygen and nitrogen species. It has been shown that autophagy is readily induced by reactive oxygen species (ROS) upon nutrient deprivation. In recent years, research has increasingly focused on outlining novel therapeutic targets related to the autophagy process. With this review of the literature, we want to give an overview about the link between autophagy, oxidative stress and carcinogenesis.
Summary Background In the last two decades, both treatment options and epidemiological features o... more Summary Background In the last two decades, both treatment options and epidemiological features of cancer have changed. We studied the influence of related parameters on the outcome of patients undergoing resection for esophageal carcinoma. Methods We analyzed 499 consecutive patients who underwent esophagectomy for carcinoma since January 2000, comparing 2000–2010 with 2011–2021 and examining changes over time. Results The percentage of men (87.9 vs. 86.9%; p = 0.74) in the two groups was unchanged, whereas mean age increased significantly from 60.8 to 65.2 years (p = 0.000). There was a trend towards an increase of adenocarcinoma (gamma = 0.120, ASE = 0.055). Despite significantly increasing use of induction chemoradiotherapy (p = 0.000) from 7.14% in 2000 to 68.9% in 2021 the distribution of pT, pN stage, grading and the rate of positive lateral resection margins remained unchanged. When comparing the two periods, the overall 30-day mortality was 4.4 vs. 4.2% (p = 0.56), recurren...
Summary Background In the last two decades, both treatment options and epidemiological features o... more Summary Background In the last two decades, both treatment options and epidemiological features of cancer have changed. We studied the influence of related parameters on the outcome of patients undergoing resection for esophageal carcinoma. Methods We analyzed 499 consecutive patients who underwent esophagectomy for carcinoma since January 2000, comparing 2000–2010 with 2011–2021 and examining changes over time. Results The percentage of men (87.9 vs. 86.9%; p = 0.74) in the two groups was unchanged, whereas mean age increased significantly from 60.8 to 65.2 years (p = 0.000). There was a trend towards an increase of adenocarcinoma (gamma = 0.120, ASE = 0.055). Despite significantly increasing use of induction chemoradiotherapy (p = 0.000) from 7.14% in 2000 to 68.9% in 2021 the distribution of pT, pN stage, grading and the rate of positive lateral resection margins remained unchanged. When comparing the two periods, the overall 30-day mortality was 4.4 vs. 4.2% (p = 0.56), recurren...
[SARS-CoV-2-associated pneumothorax, pneumomediastinum and soft tissue emphysema. Clinical implications based on a case series]
The new coronavirus (SARS-CoV-2) that arose in 2019 causes a wide spectrum of symptoms and differ... more The new coronavirus (SARS-CoV-2) that arose in 2019 causes a wide spectrum of symptoms and different courses of disease. Pneumothorax, pneumomediastinum and soft tissue emphysema are rare complications in patients with pulmonary involvement. They are the sequelae of severe, virus-induced structural changes of the pulmonary architecture. High pressure artificial ventilation aggravates the problem. Hence pneumothorax and ectopic air in soft tissues are indicators of extensive pulmonary damage. Therefore, efforts should be made to treat even very small or multiply recurrent pneumothorax by drainage procedures.
Background: Pulmonary metastasectomy (PM) has commonly been performed in patients with controlled... more Background: Pulmonary metastasectomy (PM) has commonly been performed in patients with controlled metastatic sarcoma. We reviewed our single-institution experience with pulmonary resections for sarcoma to analyse clinical outcome and to identify prognostic factors associated with patient survival. Methods: All sarcoma patients undergoing curative intent PM between 2008 and 2014 were retrospectively analysed. Factors related to primary tumour, metastases, applied therapy, systematic inflammation and preoperative nutritional condition, associated with survival after PM were evaluated using the univariable Cox proportional hazard model. Cutoff values of continuous variables were determined by a receiver operating characteristic (ROC) analysis. Results: In total, 33 patients (19 male and 14 female, median age 55 years) underwent PM for metastatic sarcoma. There were no perioperative deaths; major complications occurred in 5 (15.2%) patients. The median interval between the treatment of primary tumour and PM was 16 months (range, 0-171 months). The median size of the largest pulmonary lesion was 1.3 cm. Mean follow-up was 37 months (range, 1-100 months) and the 5-year overall survival (OS) rate after first PM was 40.4%. Resection was complete (R0) in 31 (93.9%) patients. In univariable analysis, a shorter interoperative interval [<30 months, hazard ratio (HR) 5.05, 95% confidence interval (CI): 1.15-22.19] and grade 3 (G3) sarcoma (HR 3.52, 95% CI: 1.01-12.25) were significant negative prognosticators. Conclusions: Despite the lack of randomized controlled trials PM for sarcomatous disease is a reasonable therapeutic option with acceptable survival in a selected patient population. In sarcoma patients with a shorter interoperative interval and G3 tumour, shorter survival after PM can be expected.
Videothorakoskopisches Sympathikus-Clipping bei einem Patienten mit Lobus venae azygos. Intraoperatives Management zur Vermeidung von potenziellen Komplikationen
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie
Zusammenfassung Einführung Sympathikus-Clipping bei vorliegendem Lobus venae azygos ist eine selt... more Zusammenfassung Einführung Sympathikus-Clipping bei vorliegendem Lobus venae azygos ist eine seltene Kombination. Aufgrund der engen anatomischen Beziehung zwischen dem Truncus sympathicus und dem Mesoazygosnetz kann das chirurgische Handling erschwert und mit potenziellen Komplikationen assoziiert sein. Indikation In unserem Fall handelt es sich um eine 25-jährige Patientin mit einer therapierefraktären palmoplantaren und axillären Hyperhidrosesymptomatik Schweregrad III und einem als Zufallsbefund präoperativ röntgenologisch diagnostizierten Lobus venae azygos. Methode Unser intraoperatives Video zeigt ein schrittweises Vorgehen bei Vorliegen eines Lobus venae azygos kombiniert mit einem endoskopischen Anschlingen und einer präzisen Clip-Applikation am Truncus sympathicus sowie die videoassistierte Reposition mit vollständiger Expansion des akzessorischen Lungenlappens zur Vermeidung von potenziellen Komplikationen. Fazit Das videothorakoskopische Sympathikus-Clipping ist bei Pati...
Bedeutung der selektiven Lebensqualitätsanalyse nach Sympathikus-Clipping bei Patienten mit lokaler Hyperhidrose
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie
Zusammenfassung Einleitung Die Hyperhidrose (HH) geht mit einer physischen und psychischen Einsch... more Zusammenfassung Einleitung Die Hyperhidrose (HH) geht mit einer physischen und psychischen Einschränkung einher. Die Behandlung umfasst sowohl konservative als auch operative Methoden und strebt eine dauerhafte Verbesserung der Lebensqualität (LQ) der Betroffenen an. Die endoskopische Sympathikusblockade (ESB) stellt eine etablierte operative Therapiemethode dar und gilt als ein effektives chirurgisches Verfahren bei Versagen der konservativen Therapieoptionen. Das Ziel unserer Studie war, die LQ-Veränderung und die Patientenzufriedenheit nach ESB durch umfangreiche Analyseverfahren zu untersuchen und entsprechende Einflussfaktoren zu identifizieren. Methoden Von Juli 2008 bis April 2016 wurden 105 Patienten wegen therapierefraktärer HH operiert. In allen Fällen wurde ein ESB entsprechend vorliegenden Hyperhidroseform und dem STS-Expertenkonsens (STS: Society of Thoracic Surgeons) durchgeführt. Die LQ und das Hyperhidrosestatus wurden anhand von detaillierten Fragebogen (ein selbst ...
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