Palmerballe3904

Chronic obstructive pulmonary disease (COPD) is a major public health problem. Loss of elastic recoil, hyperinflation and obstruction of the expiratory airflow lead to an increased breathing work, which results in dyspnea during minimal physical activity of the patients. Reduction of the lung volume in these patients leads to improvement of dyspnea, physical activity and quality of life in these patients. Beside endoscopic lung volume reduction (ELVR), lung volume reduction surgery (LVRS) represents an important and valuable treatment option for patients with advanced lung emphysema. Since the National Emphysema Treatment Trial (NETT), thoracic surgery experienced a remarkable evolution of the surgical techniques enabling safe surgery and quick recovery in this critically ill patient cohort. A paradigm shift from open surgical approaches to most minimally invasive techniques accompanied by improvement of anesthesiologic management of these patients was evident. Moreover, indications for LVRS, which were originally described in the NETT, were extended to apply for further groups of patients with advanced lung emphysema, enabling significant clinical improvement in well-selected patients with a low perioperative morbidity and mortality. The current review will give an overview of the historical approaches for LVRS, highlight the indications for LVRS and discuss the development of the surgical approaches.Lung emphysema represents a major public health burden and still accounts for five percent of all deaths worldwide. Hence, it is essential to further understand this disease in order to develop effective diagnostic and therapeutic strategies. Lung emphysema is an irreversible enlargement of the airways distal to the terminal bronchi (i.e., the alveoli) due to the destruction of the alveolar walls. The two most important causes of emphysema are (I) smoking and (II) α1-antitrypsin-deficiency. In the former lung emphysema is predominant in the upper lung parts, the latter is characterized by a predominance in the basal areas of the lungs. Since quantification and evaluation of the distribution of lung emphysema is crucial in treatment planning, imaging plays a central role. Imaging modalities in lung emphysema are manifold computed tomography (CT) imaging is nowadays the gold standard. However, emerging imaging techniques like dynamic or functional magnetic resonance imaging (MRI), scintigraphy and lately also the implementation of radiomics and artificial intelligence are more and more diffused in the evaluation, diagnosis and quantification of lung emphysema. The aim of this review is to shortly present the different subtypes of lung emphysema, to give an overview on prediction and risk assessment in emphysematous disease and to discuss not only the traditional, but also the new imaging techniques for diagnosis, quantification and evaluation of lung emphysema.Early allograft dysfunction (EAD), primary graft nonfunction (PNF) and biliary complications affect postoperative survival after liver transplantation (LT). Ischemia injury is one of the major factors affecting liver allograft functional recovery. Ischemia-free liver transplantation (IFLT) has obvious advantages for the recovery of allograft function and complication incidence compared with conventional procedures. However, its use is limited when the donor and the recipient are not in the same hospital and donors should be donor after brain death (DBD). We propose an approach to avoid double warm ischemic injury by implanting marginal donor liver directly by using normothermic machine perfusion (NMP) without re-cooling. Here, we report the first case of non-re-cooling implantation for marginal donor in LT. Donor liver biopsies before procurement showed 50% macrovesicular steatosis, and the recipient was a 67-year-old man with decompensated cirrhosis secondary to a 21-year hepatitis B virus (HBV) infection. The donor liver was maintained by NMP without re-cooling before implantation. The highest levels of alanine transaminase (ALT) and aspartate transaminase (AST) after surgery were 235 and 1,076 U/L, respectively, on the first postoperative day (POD). The patient was discharged within 2 weeks and showed good recovery. Thus, it is feasible to use Non-re-cooling implantation for marginal donor in LT.In a 68-year-old male patient with cholangitis microabscess in the liver, cavitary lung cancer of the right lower lobe was incidentally diagnosed. The patient's medical history comprised totally laparoscopic distal gastrectomy (TLDG) and cholecystectomy 9 years ago. Before TLDG, endoscopic retrograde cholangiopancreatography (ERCP) was performed because of a common bile duct stone and cholangitis. Three months ago, he was readmitted with cholangitic microabscess, and a cavitary lesion of right lower lobe was detected incidentally. Bcl-2 cleavage Hepatobiliary microabscess was improved with ERCP and antibiotic treatment. Video-assisted thoracoscopic surgery (VATS) right lower lobectomy and mediastinal lymph node dissection were undergone uneventfully. Pneumonic infiltration in the right lower lung field and hydropneumothorax on the right side were developed on postoperative day 10. Chest computed tomography showed pneumobilia and micro-bronchopleural fistula (BPF) was suspected with bronchoscopic examination. Despite antibiotics usage and thoracic suction, air leakage could not be improved. VATS Talc pleurodesis was performed on postoperative day 38. Contralateral pneumonia developed 1 week following talc pleurodesis. Furthermore, bilirubin was detected in the repeated bronchial washing and pleural fluid and they showed the same color and nature. Though ERCP and endoscopic nasobiliary drainage, the patient's condition deteriorated and the patient passed away on postoperative day 60. Bronchopleurobiliary fistula is an extremely rare complication after thoracic surgery for which surgical treatment is challenging, early recognition of a developing fistula and the aggressive treatment at an early stage can reduce the associated morbidity and mortality from the sequelae of this rare disease entity.Uveal melanoma (UM) is the most prevalent primary intraocular malignancy in adults. Despite a high rate of success in controlling it as a local disease, it is prone to distant metastasis, and its mechanism of metastasis has not been elucidated. This study analyzes trends in UM research and compares contributions from different countries, regions, institutions and authors. We collected all publications related to UM published from 2000 to 2020 from the Web of Science database. GraphPad Prism 6 was used to collect publication data and analyze publication trends. VOSviewer was used for data visualization. A total of 1,710 publications were considered. The United States contributed the most publications [668] and citations (19,605 times) as of 2020 with the highest H-index value [67]. Keywords were classified into three clusters, namely, clinical study, tumor-related study and gene mutation-related study. Average appearing years (AAY) of keywords were calculated. BAP1 (AAY of 2016.3), SF3B1 (AAY of 2015.8) and GNA11 (AAY of 2015.