[Spontaneous pneumothorax in chronic obstructive lung disease]. / Der Spontanpneumothorax bei chronisch obstruktiver Lungenkrankheit.

In the present study the aims were to analyse the difference in various treatment, complications and recurrence rates between patients with spontaneous pneumothorax and those associated with chronic obstructive lung disease (COLD). We made a retrospective analysis with regard to the therapy of all patients with spontaneous pneumothorax who were treated in the district lung hospital Lostau from 1. Jan 1986 to 31. Dec 1988 (171 patients, men: 136, women: 35). 45 patients suffered from a COLD (men: 42, women: 3). 3 methods of the treatment were set in: 1. conservative management by expectant observation, 2. the aspiration once or repeatedly with the pneumothorax apparatus and 3. the rubber-tube drainage. We consider the aspiration of spontaneous pneumothorax with pneumothorax apparatus as an effective method, which is not very burdensome for the patients. It is our opinion that the practice in patients with a COLD is more active than this in other patients, in form of the rubber-tube drainage.

[Reexpansion edema of the lung as a complication of the treatment of a spontaneous pneumothorax]. / Das Reexpansions-Odem der Lunge als Komplikation der Therapie eines Spontanpneumothorax.

It is reported on a 51-year-old patient in whom a reexpansion edema of the lung occurred after treatment of a pneumothorax. As a cause of the development of this complication, a high negative intrathoracic pressure is of high importance. Further pathogenetic factors are discussed.

[Internal medicine treatment of pleural empyema]. / Die internistische Behandlung des Pleuraempyems.

We made a retrospective analysis with regard to the bacteriology and to the therapy of all patients with pleural empyema who were treated in the district lung hospital from 1. 1. 1982-31. 12. 1986. 92 patients had a non-specific empyema, only 3 patients had a specific empyema. All patients were aspirated repeatedly with physiological saline solution instillation and antimicrobic drug instillation in the pleural cavity. This daily aspiration and lavage was successfully in 65 patients. This method was ineffective in 30 patients. We treated 7 patients of this group by the closed drainage (rubber-tube drain), in 4 patients successfully. 3 patients had to be treated by a surgical operation. An insufficient obliteration of the cavity of empyema occurred also in 23 patients of this group. A systematic daily aspiration for a longer time led to regression of the cavity in 4 cases, whereas a surgical operation was necessary in 19 patients. We consider the daily aspiration and lavage as an effective method in patients in early acute stages of empyema.

[Treatment of spontaneous pneumothorax from the pulmonary internal medicine viewpoint]. / Die Behandlung des Spontanpneumothorax aus pulmologisch-internistischer Sicht.

We made a retrospective analysis with regard to the therapy of all patients with spontaneous pneumothorax who were treated in the district lung hospital Lostau from 1. 1. 1983 to 30. 6. 1985. We waited for the spontaneous regression at 10 patients with a partial pneumothorax, the relapse rate was 30% in these cases. Sixty three patients were aspirated once or repeatedly with the pneumothorax apparatus. Our own success rate was 78% with this therapy, the relapse rate 26%. We treated 18 patients by rubber-tube drain. It was successful in 94%, the relapse rate was 19%. A thoracoscopy with pleurodesis was necessary in one patient who was generally inoperable. Five patients were treated primarily surgically. The same therapy was carried out in 6 patients with bullous emphysema in the free period. We consider the aspiration of spontaneous pneumothorax with pneumothorax apparatus as an effective method, which is not very burden some for the patients. The continuous suction drainage was very important too in the differential therapy of our patients.

[Asbestos carcinogenesis from clinical and hypothetical viewpoints]. / Zur Asbestkanzerogenese aus klinischer und hypothetischer Sicht.

On the basis of a case of mesothelioma of the pleura in a 28-year-old female who among our patients had the longest survival time after establishment of the diagnosis (31 months) the authors adopt a definite attitude to the problems of asbestosis. It can be regarded as ascertained that after asbest exposition a systemic contamination of the organism occurs. Apart from the inhalative intake further possibilities of the asbest fibre incorporation and the elimination are referred to. As to the cancerogenesis of asbest-induced malignomas the existing theories appear at present still insufficient; analogies to Virchow's irritation theory are possible in the serosa tumours.