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The overproduction of altered collagen fibers and the overexpression of Tumor Growth Factor-β must be blocked in order to interrupt the growth process within a keloid scar. This can barely be achieved with the classical therapeutic methods. The results of keloid treatment are difficult to predict and the recurrence rate is usually over 50 %. In addition, some of the procedures used (e. g. irradiation) may induce additional health risks. Intralesional cryosurgery offers a therapeutic alternative that has been evaluated since more than a decade. Our own experience in more than one thousand keloid treatments allows a critical evaluation of the classification in those keloid types, which are recommended to be treated with the technique and those, which may not respond.Die Überproduktion veränderter Kollagenfasern und die Überexpression von Tumor-Growth-Factor-β muss gehemmt werden, um den Wachstumsprozess innerhalb einer Keloidnarbe zu unterbrechen. Dies kann mit den klassischen Therapieverfahren kaum gelingen. Die Behandlungsergebnisse der Keloidtherapie sind nur schwer vorherzusagen und die Rezidivrate liegt meist über 50 %. Darüber hinaus können einige der eingesetzten Verfahren (z. B. Bestrahlung) zusätzliche gesundheitliche Risiken verursachen. Die intraläsionale Kryochirurgie bietet eine seit nunmehr 10 Jahren erprobte Therapiealternative an. Eigene Ergebnisse von weit über tausend Behandlungen von Patienten mit Keloiden ermöglichen eine kritische Analyse, um eine Unterscheidung der Keloide, die gut zu behandeln sind, von denen, die sich für eine Behandlung weniger oder gar nicht eignen, treffen zu können.

There still is controversy about surgical treatment of pleural empyema in children.Retrospective analysis of treatment strategy, focussing on indication for surgery and outcome of children treated in 2 centres for pleural complications due to primary pneumonia from January 1(st) 2008 to December 31(st) 2012. RESULTS were compared to studies published within the last 10 years.1 451 children with pneumonia were treated during the 5 year period. 187 (average age 6.1 years, sex: 86/101 f/m) developed a pleural effusion.pleural punction in 22 children, chest tube in 78 and operation in 37 children. In 9 cases microorganisms were identified. 34 children were operated for empyema stage II, only 3 for stage III. 3 children were operated due to septicaemia not responding to antibiotics. Time from admission to operation (including referring hospital):14.5 days. Time from operation to discharge: 12,5 days. All children but one were operated by thoracoscopy.1 bronchopleural fistula, 1 delayed healing of the wound. All children survived and fully recovered mean (observation period 28 months postoperatively).In experienced hands thoracic surgery yields excellent results for children suffering from pleural empyema stage II and III. Recent randomised prospective trials comparing fibrinolysis with VATS do not convince regarding the treatment protocols of their surgical arms. Fibrinolysis is nevertheless a valuable treatment in early stage II empyema, especially if thoracic surgical experience is not available. However, the further advanced the empyema presents, the sooner surgical experience should be gathered.

Einleitung: Sarkome sind eine heterogene Gruppe bösartiger Tumoren, die aus den Geweben des mittleren Keimblatts hervorgehen. Besonders die langsam wachsenden Sarkome des Erwachsenenalters können nur schlecht mit den gängigen Chemotherapeutika behandelt werden.Synthetische Host-Defense-Peptide,[for full text, please go to the a.m. URL], 126. Kongress der Deutschen Gesellschaft für Chirurgie