High-pressure injection injuries (HPII) caused by water swelling sealant are rare at present. The patient generally has small-sized skin lesions, and the misleadingly benign presentation may cause delayed treatment at the early stage of management. In addition, radiographic examination may be underestimated. Subsequently, the inadequate surgical intervention may cause tissue necrosis and poor prognosis. Furthermore, the early recognition of water swelling sealant injected into tissue and emergent surgical intervention are the key to successful management for the patient with HPII caused by injecting water swelling sealant to tissue.

High-Pressure Water Swelling Sealant Injection Injury to the Hand: a Case Report and Review of the Literature

Starting with the present issue of Langenbeck’s Archives of Surgery, the journal comes with a new cover and Editorial Board. Under the former Editor-in-Chief Professor Beger, Langenbeck’s Archives of Surgery has been established as an internationally accepted, competitive, Englishpublishing journal with increasing impact during the past 12 years. The continuing aim of Langenbeck’s Archives of Surgery is to publish top results within the field of clinical surgery and basic surgical research. This issue launches a new series of paired first-rate review articles on related clinical and scientific topics authored by leading international experts in their field. These reviews are selectively invited by the editor-in-chief, but regularly submitted outstanding reviews are also welcome and considered for this novel journal section. The present issue features two invited review articles on the subject of intestinal ischemia. Brigitte Vollmar and Michael D. Menger excellently illustrate the current knowledge of microcirculatory pathology and functional consequences [1]. The challenging clinical treatment concept of intestinal ischemia is outlined and updated by the group of Hans J. Schlitt [2]. Both reviews inspire clinical trials that focus on novel complex molecular pathogenic mechanisms in order to accomplish further progress in the management of intestinal ischemic and reperfusion injury. Future types of manuscripts evaluated for publication in Langenbeck’s Archives of Surgery will also include rapid communications reporting cutting-edge findings of high relevance. For those articles, the editorial board guarantees a distinct quick peer-review process. Surgeons are welcome to submit pioneering surgical techniques and treatment concepts in the journal’s “How-Ido-it”-section. A focus will be placed on data from controlled clinical trials and systematic reviews or meta-analysis. We warmly thank all people that contributed to the updated content and design of Langenbeck’s Archives of Surgery, and hope that the readers enjoy and benefit from the presented articles in the this issue.

/pdf/langenbeck-s-archives-of-surgery-2011-new-concepts-and-3wg3e4zz2h.pdf

Langenbeck's archives of surgery 2011: new concepts and design.

OBJECTIVE To investigate whether fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) combined with thin-section CT improves the diagnostic performance for solitary pulmonary nodules (SPNs). METHODS A total of 267 patients underwent examinations with 18F-FDG PET/CT and thin-section CT for evaluating the SPNs with undetermined nature, which was further confirmed by pathological examination or clinical follow-up. The performance of two diagnostic criteria based on findings in PET/CT alone (Criterion 1) and in PET/CT combined with thin-section CT (Criterion 2) were compared. RESULTS Thin-section CT provided greater diagnostic information for SPNs in 84.2% of the patients. Compared with Criterion 1, the diagnosis based on Criterion 2 significantly increased the diagnostic sensitivity (80.4% vs 91%, P<0.01) and accuracy (76.4% vs 87.2%, P<0.01) for lung cancer. The lesion size and the CT features including lobulation, air bronchogram, and feeding vessel, but not SUVmax, were all helpful for characterizing non-solid SPNs. Thin-section CT rectified diagnostic errors in 50% (20/40) of the cancerous lesions, which had been diagnosed as benign by PET due to their low metabolism. For non-solid SPNs, Criterion 2 showed a significantly higher diagnostic sensitivity than Criterion 1 (90.0% vs 40.0%, P=0.000) but their diagnostic specificity were comparable (75.2% vs 58.3%, P=0.667). For solid nodules, the use of thin-section CT resulted in no significant improvement in the diagnostic performance (P<0.05). CONCLUSION The combination of PET/CT and thin-section CT creates a synergistic effect for the characterization of SPNs, especially non-solid nodules.

Combined use of thin-section CT and 18 F-FDG PET/CT for characterization of solitary pulmonary nodules

Lung cancer occurs with a median age of 69 years. The main cause is cigarette smoking. For both genders lung cancer is the third-most frequent tumor in Germany. While in an operable tumor stage 30-80% of the patients can reach long-term survival, the prognosis in the metastasised stage is unfavourable with a 5-year overall survival rate of 6% for small cell lung cancer (SCLC) and 18% for non-small cell lung cancer (NSCLC). Lung cancer is subject of intense research to improve the outcome. This article gives an overview of current treatment options.

Current treatment concepts of lung cancer

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Current treatment concepts of lung cancer