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Zeit für eine Neubewertung der thorakoskopischen Lobektomie und deren Stellenwert in der Thoraxonkologie!
Witte, Biruta
GMS Thoracic Surgical Science , 2009,
Lymphomas presenting as chest wall tumors
Witte, Biruta,Hürtgen, Martin
GMS Thoracic Surgical Science , 2006,
Abstract: Four cases of thoracic lymphoma mimicking chest wall tumors are presented. As resection is not the treatment of first choice in lymphomas, pretherapeutical evaluation of chest wall tumors should include a thoroughly staging and a biopsy for histopathological diagnosis. Chest wall destruction due to an anterior mediastinal mass, or a chest wall tumor associated with mediastinal lymph node enlargement, could be suspicious of thoracic lymphoma. Lymphoma with chest wall involvement mostly turns out to be Hodgkin's disease or large B-cell lymphoma. Stage and histopathological diagnosis have major impact on treatment and prognosis. Therapy is chemotherapy or chemo-radiation.
Systematic Video-Assisted Mediastinoscopic Lymphadenectomy (VAMLA)
Hürtgen, Martin,Friedel, Godehard,Witte, Biruta,Toomes, Heikki
GMS Thoracic Surgical Science , 2005,
Abstract: Accurate mediastinal lymph node dissection during thoracotomy is mandatory for staging and for adjuvant therapy in lung cancer. Pre-therapeutic staging for neoadjuvant therapy or for video assisted thoracoscopic resection of lung cancer is achieved usually by CT-scan and mediastinoscopy. However, these methods do not reach the accuracy of open nodal dissection. Therefore we developed a technique of radical video-assisted mediastinoscopic lymphadenectomy (VAMLA). This study was designed to show that VAMLA is feasible and that radicality of lymphadenectomy is comparable to the open procedure.In a prospective study all VAMLA procedures were registered and followed up in a database. Specimens of VAMLA were analysed by a single pathologist. Lymph nodes were counted and compared to open lymphadenectomy. The weight of the dissected tissue was documented. In patients receiving tumour resection subsequently to VAMLA, radicality of the previous mediastinoscopic dissection was controlled during thoracotomy.37 patients underwent video-assisted mediastinoscopy from June 1999 to April 2000. Mean duration of anaesthesia was 84.6 (SD 35.8) minutes.In 7 patients radical lymphadenectomy was not intended because of bulky nodal disease or benign disease. The remaining 30 patients underwent complete systematic nodal dissection as VAMLA.18 patients received tumour resection subsequently (12 right- and 6 left-sided thoracotomies). These thoracotomies allowed open re-dissection of 12 paratracheal regions, 10 of which were found free of lymphatic tissue. In two patients, 1 and 2 left over paratracheal nodes were counted respectively. 10/18 re-dissected subcarinal regions were found to be radically dissected by VAMLA. In 6 patients one single node and in the remaining 2 cases 5 and 8 nodes were found, respectively. However these counts also included nodes from the ipsilateral main bronchus. None of these nodes was positive for tumour.Average weight of the tissue that was harvested by VAMLA was 10.1 g (2.2-23.7, SD 6.3). An average number of 20.5 (6-60, SD 12.5) nodes per patient were counted in the specimens. This is comparable to our historical data from open lymphadenectomy.One palsy of the recurrent nerve in a patient with extensive preparation of the nerve and resection of 11 left-sided enlarged nodes was the only severe complication in this series.VAMLA seems to accomplish mediastinal nodal dissection comparable to open lymphadenectomy and supports video assisted surgery for lung cancer. In neoadjuvant setting a correct mediastinal N-staging is achieved.
Snow Mould Development under Conditions of Central Part of Latvia
Biruta Bankina , Antons Ruza , Merabs Katamadze , Dzintra Kreita , Līga Paura
Proceedings of the Latvia University of Agriculture , 2012, DOI: 10.2478/v10236-012-0001-6
Abstract: Snow mould is a common disease of winter cereals in moderate and cold climatic areas. Snow mould of winter cereals has been observed sporadically in Latvia. Sharp development of this disease (caused by Microdochium nivale) was noticed in 2005-2007. The aim of the investigations was to clarify peculiarities of snow mould development depending on different agroecological conditions. Observations of snow mould incidence were carried out in the central part of Latvia - at the Study and research farm "Peterlauki" of the Latvia University of Agriculture during 2005-2008. The average incidence of snow mould was 40% (5-60%) in 2005, 31% (14-63%) in 2006, and 36% (2-95%) in 2007. The highest incidence of the disease was established for cultivar ‘Cubus’ (23-95% depending on the year and the sowing time). A moderate development of snow mould was observed for variety ‘Zentos’ (5-60%), but only 2-50% of damaged plants were found for ‘Tarso’. The main reason of sharp development of the disease was too early sowing of winter wheat, whereas late time of wheat sowing, on average, significantly decreased the development of snow mould (p<0.001). Further investigations are necessary to better understand the complex of factors which influenced wheat susceptibility against snow mould.
Intraosseous Lipoma of the Sphenoid: A Case Study
Zygmunt Jamrozik,Grzegorz Rosiak,Biruta Kierdaszuk,Krzysztof Milczarek,Anna Kamińska,Dorota Dziewulska,Antoni Krzeski
Case Reports in Neurological Medicine , 2013, DOI: 10.1155/2013/519341
Abstract: Intraosseous lipoma is very rare, usually benign tumor of flat bones. However, the localization in skull bones is described in sporadic cases. The differential diagnosis includes end stage of infection, infarct lesions, intraosseous meningioma, angiolipoma, or myxofibrous tumors. We report a patient with intraosseous lipoma located in the sphenoid bone. The diagnosis was established due to the characteristic radiological features. According to the history of seizures, the lesion was removed via endoscopic endonasal approach. Histopathological examination showed adipocytes. The patient underwent control neuroimaging studies. 1. Introduction Intraosseous lipoma (IL) is a rarely diagnosed, usually benign tumor placed in the flat bones, hardly ever in the long bones. Most often reported localizations include calcaneus, rib, and frontal and basal skull [1–3]. Lipoma originates from mesenchymal tissue and might resemble other benign tumors. Incidence of sphenoid bone and sphenoid sinus lipoma seems to be very rare although precise epidemiological data are not known [4–6]. It has been postulated that intraosseous lipomas grow as a result of infarct, end stage of infection, fibrous dysplasia, fibro- and angiolipoma, or liposclerosing myxofibrous tumors (LSMFT). All those should be included in the differential diagnosis of the intraosseous lipoma. 2. Case Report A patient, 23-year-old woman, has been referred to neurological department by an ophthalmologist with suspected papilledema. Two weeks earlier, she suffered from the first generalized tonic-clonic seizure after unexpected sudden pain. Medical history includes 2 attacks of unconsciousness after acute pain. A CT scan revealed a hypodense mass with central calcifications within sphenoid sinus and clivus. Density of the hypodense portion of mass ranged from ?30 to ?90 Hounsfield units suggesting presence of fat which surrounded central, scattered calcifications. Multilobulated margins of the lesion were sharp and sclerotic suggesting nonaggressive growth (Figure 1). MR scans showed a sphenoclival mass hyperintense in both T1WI (SE) and T2WI (TSE) with sharp and thin margin of low signal intensity corresponding with sclerotic rim. Cortex of sella turcica and clivus were intact. Fat suppressed sequence confirmed fat containing lesion; incomplete signal suppression was due to central calcifications. The lesion showed no contrast enhancement (Figure 2). Upon findings in both imaging modalities, a diagnosis of intraosseous lipoma was made. Figure 1: Routine CT scan revealed intraosseous lipoma within the sphenoid
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