INTRODUCTION Myeloid derived suppressor cells (MDSCs) are one of the major components of the tumor microenvironment. The accumulation of MDSCs has been demonstrated in many types of human solid tumors. However, the relevance of this heterogeneous population in hematopoietic malignancies has only recently gained stronger attention. MDSCs are a phenotypically and functionally heterogeneous group of cells. The results of recent studies indicate that the immune dysregulation in chronic lymphocytic leukemia (CLL) affects a monocytic MDSC (M-MDSC) subpopulation. This study aimed to analyze the frequency of M-MDSCs with intracellular IL-10 and TGF-β1 expression in newly diagnosed CLL patients. We investigated the potential role of M-MDSCs in CLL by analyzing the level of IL-10 and TGF-β1 expression in circulating M-MDSCs in correlation with clinical and laboratory parameters characterizing disease activity and patients’ immune status. MATERIAL AND METHODS Seventy CLL patients and 17 age-matched healthy volunteers weuiring therapy as compared to patients without treatment during the observation period. CONCLUSION In conclusion, we have shown that an increased percentage of M-MDSC cells producing IL-10 and TGF-β1 in CLL patients may be associated with the suppression of the immune response against CLL. It can be assumed that the increased percentage of M-MDSC with an intracellular expression of IL-10 and TGF-β1 may be used in the future as the factor defining the group of patients with shorter time to onset of treatment.OBJECTIVES To describe a transforaminal endoscopic spinal decompression technique for treating adult patients with isthmic spondylolisthesis and report preliminary surgical and radiological results. BACKGROUND Spondylolisthesis is prevalent in the general population. Surgical approaches for symptomatic spondylolisthesis that is refractory to conservative treatment vary. Direct repair of pars fractures and spinal nerve decompression with or without fusion have been reported with varied clinical results. The de facto gold standard, “fusion,” is often associated with high complication rates and costs, and may not be necessary for many patients whose spine is relatively stable. METHODS Transforaminal endoscopic lumbar decompression (TFELD) was performed to resect fractured bone or bone fragments and inflamed tissue compressing the exiting nerve root in 2 patients with isthmic spondylolisthesis (grade 1 in one patient and grade 2 in another). We describe the technique step*by-step and assess the Oswestry Disability Index and pain scores for back and leg pain before and after surgery. RESULTS Radiographic images demonstrated spondylolisthesis with L5 pars fracture. The fractured bone and bone fragment were intraoperatively visible in the gap between facets and fractured pars in patients with isthmic spondylolisthesis. The core pathology of the patients was fractured bone and bone fragment coupled with scar or inflamed tissue compressing the exiting L5 nerve roots. After the bone fragments and scar tissue were removed using TFELD, the patients’ back and leg pain was significantly reduced, and physical function was restored. CONCLUSION For patients with spondylolisthesis-associated low back and leg pain without spinal instability, TFELD is a safe and effective surgical treatment option.PURPOSE To investigate the safety and outcomes of laparoscopic control of intraperitoneal mesh positioning in open umbilical hernia repair. METHODS This study is a retrospective review of a series of adult patients with uncomplicated umbilical hernia who underwent elective open repair with a self-expanding patch with laparoscopic control from March 2011 to December 2018. The adequacy of mesh positioning was inspected with a 5-mm 30° scope in the left flank. The primary endpoint was recurrence. this website Secondary endpoints were rate of mesh repositioning, intraoperative complications and time, length of stay and postoperative pain. RESULTS Thirty-five patients underwent open inlay repair of primary umbilical hernia with laparoscopic control. Six patients (17.1%) were obese. The mean operating time was 63.3 min. The mean defect size was 2.6 cm (0.6-5) and the mean mesh overlap was 3.2cm (2.2-4.5). There were no intraoperative complications. Laparoscopic control required mesh repositioning in 5 cases (14.3%). The median length of stay was 2 days. Perioperative complications were recorded in three cases (8.6%) one seroma and two serous wound discharge (Clavien-Dindo I). The recurrence rate was 2.9% (1 case) at a median follow-up of 60 months. BMI>30 was associated with a higher rate of intraoperative mesh repositioning (p=0.001). Non-reabsorbable mesh and COPD were associated with a higher incidence of postoperative complications (p=0.043). Postoperative pain scores were consistently at mild levels, with no statistically significant differences between patients who had their mesh repositioned and those who had not. CONCLUSIONS Laparoscopic control of mesh positioning is a safe addition to open inlay umbilical hernia repair and enables the accurate verification of correct mesh deployment with low complication and recurrence rates.in English, German Die idiopathische Lungenfibrose (IPF) ist eine schwerwiegende, chronische Lungenerkrankung, deren Diagnosestellung eine profunde fachliche Expertise verlangt. Seit Veröffentlichung der internationalen IPF-Leitlinie im Jahr 2011 mit Update 2018 haben zahlreiche Studien und technische Fortschritte eine Neubewertung des diagnostischen Vorgehens notwendig gemacht. Angesichts der Indikation, symptomatischen Patienten eine antifibrotische Therapie sofort nach Diagnosestellung zu empfehlen, hat die aktuelle IPF-Diagnostik-Leitlinie zum Ziel, die Diagnose der IPF möglichst ohne Verzögerung, wenig invasiv und zuverlässig zu ermöglichen. Sie beschreibt den typischen klinischen Kontext der IPF sowie die Untersuchungen, die zum Ausschluss bekannter Ursachen einer Lungenfibrose erforderlich sind, einschließlich standardisierter Anamneseerhebung, serologischer Testungen und zellulärer Analyse der bronchoalveolären Lavage. Zentrale Bedeutung kommt dem hochauflösenden Computertomogramm in Dünnschichttechnik zu.