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- Theodor-Boveri-Institut für Biowissenschaften (74)
- Physikalisches Institut (41)
- Graduate School of Life Sciences (31)
- Institut für Psychologie (24)
- Institut für Theoretische Physik und Astrophysik (24)
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- Rudolf-Virchow-Zentrum (19)
- Neurologische Klinik und Poliklinik (18)
- Institut für Molekulare Infektionsbiologie (17)
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Sonstige beteiligte Institutionen
- Johns Hopkins School of Medicine, Baltimore, MD, U.S. (4)
- Institut für Optik und Atomare Physik, Technische Universität Berlin, 10623 Berlin, Germany (2)
- Laboratory for Chemistry and Life Science, Institute of Innovative Research, Tokyo Institute of Technology, Yokohama 226-8503, Japan (2)
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ResearcherID
- M-1240-2017 (1)
When More Is Better – Consumption Priming Decreases Responders’ Rejections in the Ultimatum Game
(2017)
During the past decades, economic theories of rational choice have been exposed to outcomes that were severe challenges to their claim of universal validity. For example, traditional theories cannot account for refusals to cooperate if cooperation would result in higher payoffs. A prominent illustration are responders’ rejections of positive but unequal payoffs in the Ultimatum Game. To accommodate this anomaly in a rational framework one needs to assume both a preference for higher payoffs and a preference for equal payoffs. The current set of studies shows that the relative weight of these preference components depends on external conditions and that consumption priming may decrease responders’ rejections of unequal payoffs. Specifically, we demonstrate that increasing the accessibility of consumption-related information accentuates the preference for higher payoffs. Furthermore, consumption priming increased responders’ reaction times for unequal payoffs which suggests an increased conflict between both preference components. While these results may also be integrated into existing social preference models, we try to identify some basic psychological processes underlying economic decision making. Going beyond the Ultimatum Game, we propose that a distinction between comparative and deductive evaluations may provide a more general framework to account for various anomalies in behavioral economics.
Context: Patients with primary adrenal insufficiency (PAI) or congenital adrenal hyperplasia (CAH) are at a high risk of adrenal crisis (AC). Glucocorticoid sensitivity is at least partially genetically determined by polymorphisms of the glucocorticoid receptor (GR).
Objectives: To determine if a number of intercurrent illnesses and AC are associated with the GR gene polymorphism \(Bcl\)I in patients with PAI and CAH.
Design and patients: This prospective, longitudinal study over 37.7 ± 10.1 months included 47 PAI and 25 CAH patients. During the study period, intercurrent illness episodes and AC were documented.
Results: The study period covered 223 patient years in which 21 AC occurred (9.4 AC/100 pat years). There were no significant differences between \(Bcl\)I polymorphisms (CC (n=29), CG (n=34) and GG (n=9)) regarding BMI, hydrocortisone equivalent daily dose and blood pressure. We did not find a difference in the number of intercurrent illnesses/patient year among \(Bcl\)I polymorphisms (CC (1.5±1.4/pat year), CG (1.2±1.2/pat year) and GG (1.6±2.2/pat year)). The occurrence of AC was not significantly different among the homozygous (GG) genotype (32.5 AC/100 pat years), the CC genotype (6.7 AC/100 pat years) and the CG genotype (4.9 AC/100 pat years). Concomitant hypothyroidism was the highest in the GG genotype group (5/9), compared to others (CC (11/29) and CG (11/34)).
Conclusions: Although sample sizes were relatively small and results should be interpreted with caution, this study suggests that the GR gene polymorphism \(Bcl\)I may not be associated with the frequencies of intercurrent illnesses and AC.
Purpose: Research dealing with ischemic preconditioning (IPC) has primarily focused on variables associated to endurance performance with little research about the acute responses of IPC on repeated multidirectional running sprint performance. Here we aimed to investigate the effects of IPC of the arms and the legs on repeated running sprint performance with changes-of-direction (COD) movements.
Methods: Thirteen moderately-to-well-trained team-sport athletes (7 males; 6 females; age: 24 ± 2 years, size: 175 ± 8 cm, body mass: 67.9 ± 8.1 kg) performed 16 × 30 m all-out sprints (15 s rest) with multidirectional COD movements on a Speedcourt\(^{©}\) with IPC (3 × 5 min) of the legs (IPC\(_{leg}\); 240 mm Hg) or of the arms (remote IPC: IPC\(_{remote}\); 180–190 mm Hg) 45 min before the sprints and a control trial (CON; 20 mm Hg).
Results: The mean (±SD) time for the 16 × 30 m multidirectional COD sprints was similar between IPC\(_{leg}\) (Mean t: 16.0 ± 1.8 s), IPC\(_{remote}\) (16.2 ± 1.7 s), and CON (16.0 ± 1.6 s; p = 0.50). No statistical differences in oxygen uptake (mean difference: 0%), heart rate (1.1%) nor muscle oxygen saturation of the vastus lateralis (4.7%) and biceps brachii (7.8%) between the three conditions were evident (all p > 0.05).
Conclusions: IPC (3 × 5 min) of the legs (220 mm Hg) or arms (180–190 mm Hg; remote IPC) applied 45 min before 16 × 30 m repeated multidirectional running sprint exercise does not improve sprint performance, oxygen uptake, heart rate nor muscle oxygen saturation of the vastus lateralis muscle when compared to a control trial.
For persistent infections of the mammalian host, African trypanosomes limit their population size by quorum sensing of the parasite-excreted stumpy induction factor (SIF), which induces development to the tsetse-infective stumpy stage. We found that besides this cell density-dependent mechanism, there exists a second path to the stumpy stage that is linked to antigenic variation, the main instrument of parasite virulence. The expression of a second variant surface glycoprotein (VSG) leads to transcriptional attenuation of the VSG expression site (ES) and immediate development to tsetse fly infective stumpy parasites. This path is independent of SIF and solely controlled by the transcriptional status of the ES. In pleomorphic trypanosomes varying degrees of ES-attenuation result in phenotypic plasticity. While full ES-attenuation causes irreversible stumpy development, milder attenuation may open a time window for rescuing an unsuccessful antigenic switch, a scenario that so far has not been considered as important for parasite survival.
Aspergillus (A.) fumigatus is an opportunistic fungal mold inducing invasive aspergillosis (IA) in immunocompromised patients. Although antifungal activity of human natural killer (NK) cells was shown in previous studies, the underlying cellular mechanisms and pathogen recognition receptors (PRRs) are still unknown. Using flow cytometry we were able to show that the fluorescence positivity of the surface receptor CD56 significantly decreased upon fungal contact. To visualize the interaction site of NK cells and A. fumigatus we used SEM, CLSM and dSTORM techniques, which clearly demonstrated that NK cells directly interact with A. fumigatus via CD56 and that CD56 is re-organized and accumulated at this interaction site time-dependently. The inhibition of the cytoskeleton showed that the receptor re-organization was an active process dependent on actin re-arrangements. Furthermore, we could show that CD56 plays a role in the fungus mediated NK cell activation, since blocking of CD56 surface receptor reduced fungal mediated NK cell activation and reduced cytokine secretion. These results confirmed the direct interaction of NK cells and A. fumigatus, leading to the conclusion that CD56 is a pathogen recognition receptor. These findings give new insights into the functional role of CD56 in the pathogen recognition during the innate immune response.
Background:
Clinical reasoning in Neurology is based on general associations which help to deduce the site of the lesion. However, even “golden principles” may occasionally be deceptive. Here, we describe the case of subacute flaccid tetraparesis due to motor cortical lesions. To our knowledge, this is the first report to include an impressive illustration of nearly symmetric motor cortical involvement of encephalitis on brain MRI.
Case presentation:
A 51 year old immunocompromized man developed a high-grade pure motor flaccid tetraparesis over few days. Based on clinical presentation, critical illness polyneuromyopathy was suspected. However, brain MRI revealed symmetrical hyperintensities strictly limited to the subcortical precentral gyrus. An encephalitis, possibly due to CMV infection, turned out to be the most likely cause.
Conclusion:
While recognition of basic clinical patterns is indispensable in neurological reasoning, awareness of central conditions mimicking peripheral nervous disease may be crucial to detect unsuspected, potentially treatable conditions.
Background:
Sleep-related eating may occur in the context of mental illness, sleep disorders, or psychopharmacological treatment. Frequently, sleep-related eating leads to severe weight gain and, so far, there are no treatment options for the condition.
Case presentation:
We report the case of a 54-year-old white woman with depression, panic disorder, and sleep apnea under treatment with various antidepressants who developed severe sleep-related eating. Her sleep-related eating completely vanished after addition of agomelatine, it reoccurred after cessation of agomelatine, and vanished again after her re-exposure to another melatonergic drug, extended melatonin.
Conclusions:
This case suggests that melatonergic drugs lead to relief from sleep-related eating, even when the condition occurs in the context of physical and mental disorders as well as psychopharmacological treatment.
The importance of enterprise systems is increasingly growing and they are in the center of attention and consideration by organizations in various types of business and industries from extra-large public or private organizations to small and medium-sized service sector business. These systems are continuously advancing functionally and technologically and are inevitable and ineluctable for the enterprises to maximize their productivity and integration in current competitive national and global business environments.
Also, since local software solutions could not meet the requirements of especially large enterprises functionally and technically, and as giant global enterprise software producers like SAP, Oracle and Microsoft are improving their solutions rapidly and since they are expanding their market to more corners of the globe, demand for these globally branded low-defect software solutions is daily ascending. The agreements for international ERP implementation project consultancy are, therefore, exponentially increasing, while the research on the influencing factors and know-hows is scattered and rare, and thus, a timely urgency for this field of research is being felt.
The final developed five-in-five framework of this study, for the first time, collects all mentioned-in-the-history critical success factors and project activities, while sequencing them in five phases and categorizing them in five focus areas for international ERP implementation projects. This framework provides a bird’s-eye view and draws a comprehensive roadmap or instruction for such projects.
Anionic Adducts
Sp2-sp3 tetraalkoxy diboron compounds have gained attention due to the development of new, synthetically useful catalytic reactions either with or without transition-metals. Lewis-base adducts of the diboron(4) compounds were suggested as possible intermediates in Cu catalyzed borylation reactions some time ago. However, intermolecular adducts of tetraalkoxy diboron compounds have not been studied yet in great detail. In preliminary studies, we have synthesized a series of anionic sp2-sp3 adducts of B2pin2 with alkoxy-groups (L = [OMe]–, [OtBu]–), a phenoxy-group (L = [4-tBuC6H4O]–) and fluoride (L = [F]–, with [nBu4N]+ as the counter ion) as Lewis-bases.
Neutral Adducts
Since their isolation and characterization, applications of N-heterocyclic carbenes (NHCs) and related molecules, e.g., cyclic alkylaminocarbenes (CAACs) and acyclic diaminocarbenes (aDCs), have grown rapidly. Their use as ligands in homogeneous catalysis and directly in organocatalysis, including recently developed borylation reactions, is now well established. Recently, several examples of ring expansion reactions (RER) involving NHCs were reported to take place at elevated temperatures, involving Be, B, and Si.
Furthermore, preliminary studies in the group of Marder et al. showed the presence of neutral sp2-sp3 diboron compounds with B2pin2 and the NHC Cy2Im. In this work, we focused on the synthesis and characterization of further neutral sp2-sp3 as well as sp3-sp3 diboron adducts with B2cat2 and B2neop2 and different NHCs. Whereas the mono-NHC adduct is stable for several hours at temperatures up to 60 °C, the bis-NHC adducts undergo thermally induced rearrangement to form the ring expanded products compound 26 and 27. B2neop2 is much more reactive than B2cat2 giving ring expanded product 29 at room temperature in quantitative yields, demonstrating that NHC ring expansion and B–B bond cleavage can be very facile processes.
Whereas the mono-NHC adduct is stable for several hours at temperatures up to 60 °C, the bis-NHC adducts undergo thermally induced rearrangement to form the ring expanded products compound 26 and 27. B2neop2 is much more reactive than B2cat2 giving ring expanded product 29 at room temperature in quantitative yields, demonstrating that NHC ring expansion and B–B bond cleavage can be very facile processes.
Background
Herpesviruses can infect a wide range of animal species. Herpes simplex virus 1 (HSV-1) is one of the eight herpesviruses that can infect humans and is prevalent worldwide. Herpesviruses have evolved multiple ways to adapt the infected cells to their needs, but knowledge about these transcriptional and post-transcriptional modifications is sparse.
Results
Here, we show that HSV-1 induces the expression of about 1000 antisense transcripts from the human host cell genome. A subset of these is also activated by the closely related varicella zoster virus. Antisense transcripts originate either at gene promoters or within the gene body, and they show different susceptibility to the inhibition of early and immediate early viral gene expression. Overexpression of the major viral transcription factor ICP4 is sufficient to turn on a subset of antisense transcripts. Histone marks around transcription start sites of HSV-1-induced and constitutively transcribed antisense transcripts are highly similar, indicating that the genetic loci are already poised to transcribe these novel RNAs. Furthermore, an antisense transcript overlapping with the BBC3 gene (also known as PUMA) transcriptionally silences this potent inducer of apoptosis in cis.
Conclusions
We show for the first time that a virus induces widespread antisense transcription of the host cell genome. We provide evidence that HSV-1 uses this to downregulate a strong inducer of apoptosis. Our findings open new perspectives on global and specific alterations of host cell transcription by viruses.
Strong light matter coupling between excitons and microcavity photons, as described in the framework of cavity quantum electrodynamics, leads to the hybridization of light and matter excitations. The regime of collective strong coupling arises, when various excitations from different host media are strongly coupled to the same optical resonance. This leads to a well-controllable admixture of various matter components in three hybrid polariton modes. Here, we study a cavity device with four embedded GaAs quantum wells hosting excitons that are spectrally matched to the A-valley exciton resonance of a MoSe\(_{2}\) monolayer. The formation of hybrid polariton modes is evidenced in momentum resolved photoluminescence and reflectivity studies. We describe the energy and k-vector distribution of exciton-polaritons along the hybrid modes by a thermodynamic model, which yields a very good agreement with the experiment.
Intracellular pathogenic microorganisms and toxins exploit host cell mechanisms to enter, exert their deleterious effects as well as hijack host nutrition for their development. A potential approach to treat multiple pathogen infections and that should not induce drug resistance is the use of small molecules that target host components. We identifed the compound 1-adamantyl (5-bromo-2-methoxybenzyl) amine (ABMA) from a cell-based high throughput screening for its capacity to protect human cells and mice against ricin toxin without toxicity. This compound efciently protects cells against various toxins and pathogens including viruses, intracellular bacteria and parasite. ABMA provokes Rab7-positive late endosomal compartment accumulation in mammalian cells without affecting other organelles (early endosomes, lysosomes, the Golgi apparatus, the endoplasmic reticulum or the nucleus). As the mechanism of action of ABMA is restricted to host-endosomal compartments, it reduces cell infection by pathogens that depend on this pathway to invade cells. ABMA may represent a novel class of broad-spectrum compounds with therapeutic potential against diverse severe infectious diseases.
The MuvB multiprotein complex, together with B-MYB and FOXM1 (MMB-FOXM1), plays an essential role in cell cycle progression by regulating the transcription of genes required for mitosis and cytokinesis. In many tumors, B-MYB and FOXM1 are overexpressed as part of the proliferation signature. However, the transcriptional targets that are important for oncogenesis have not been identified. Given that mitotic kinesins are highly expressed in cancer cells and that selected kinesins have been reported as target genes of MMB-FOXM1, we sought to determine which mitotic kinesins are directly regulated by MMB-FOXM1. We demonstrate that six mitotic kinesins and two microtubule-associated non-motor proteins (MAPs) CEP55 and PRC1 are direct transcriptional targets of MuvB, B-MYB and FOXM1 in breast cancer cells.
Suppression of KIF23 and PRC1 strongly suppressed proliferation of MDA-MB-231 cells. The set of MMB-FOXM1 regulated kinesins genes and 4 additional kinesins which we referred to as the mitotic kinesin signature (MKS) is linked to poor outcome in breast cancer patients. Thus, mitotic kinesins could be used as prognostic biomarker and could be potential therapeutic targets for the treatment of breast cancer.
The field of genetics faces a lot of challenges and opportunities in both research and diagnostics due to the rise of next generation sequencing (NGS), a technology that allows to sequence DNA increasingly fast and cheap.
NGS is not only used to analyze DNA, but also RNA, which is a very similar molecule also present in the cell, in both cases producing large amounts of data.
The big amount of data raises both infrastructure and usability problems, as powerful computing infrastructures are required and there are many manual steps in the data analysis which are complicated to execute.
Both of those problems limit the use of NGS in the clinic and research, by producing a bottleneck both computationally and in terms of manpower, as for many analyses geneticists lack the required computing skills.
Over the course of this thesis we investigated how computer science can help to improve this situation to reduce the complexity of this type of analysis.
We looked at how to make the analysis more accessible to increase the number of people that can perform OMICS data analysis (OMICS groups various genomics data-sources).
To approach this problem, we developed a graphical NGS data analysis pipeline aimed at a diagnostics environment while still being useful in research in close collaboration with the Human Genetics Department at the University of Würzburg.
The pipeline has been used in various research papers on covering subjects, including works with direct author participation in genomics, transcriptomics as well as epigenomics.
To further validate the graphical pipeline, a user survey was carried out which confirmed that it lowers the complexity of OMICS data analysis.
We also studied how the data analysis can be improved in terms of computing infrastructure by improving the performance of certain analysis steps.
We did this both in terms of speed improvements on a single computer (with notably variant calling being faster by up to 18 times), as well as with distributed computing to better use an existing infrastructure.
The improvements were integrated into the previously described graphical pipeline, which itself also was focused on low resource usage.
As a major contribution and to help with future development of parallel and distributed applications, for the usage in genetics or otherwise, we also looked at how to make it easier to develop such applications.
Based on the parallel object programming model (POP), we created a Java language extension called POP-Java, which allows for easy and transparent distribution of objects.
Through this development, we brought the POP model to the cloud, Hadoop clusters and present a new collaborative distributed computing model called FriendComputing.
The advances made in the different domains of this thesis have been published in various works specified in this document.
Most proteins work in aqueous solution and the interaction with water strongly affects their structure and function. However, experimentally the motion of a specific single water molecule is difficult to trace by conventional methods, because they average over the heterogeneous solvation structure of bulk water surrounding the protein. Here, we provide a detailed atomistic picture of the water rearrangement dynamics around the –CONH– peptide linkage in the two model systems formanilide and acetanilide, which simply differ by the presence of a methyl group at the peptide linkage. The combination of picosecond pump–probe time-resolved infrared spectroscopy and molecular dynamics simulations demonstrates that the solvation dynamics at the molecular level is strongly influenced by this small structural difference. The effective timescales for solvent migration triggered by ionization are mainly controlled by the efficiency of the kinetic energy redistribution rather than the shape of the potential energy surface. This approach provides a fundamental understanding of protein hydration and may help to design functional molecules in solution with tailored properties.
Most proteins work in aqueous solution and the interaction with water strongly affects their structure and function. However, experimentally the motion of a specific single water molecule is difficult to trace by conventional methods, because they average over the heterogeneous solvation structure of bulk water surrounding the protein. Here, we provide a detailed atomistic picture of the water rearrangement dynamics around the –CONH– peptide linkage in the two model systems formanilide and acetanilide, which simply differ by the presence of a methyl group at the peptide linkage. The combination of picosecond pump–probe time-resolved infrared spectroscopy and molecular dynamics simulations demonstrates that the solvation dynamics at the molecular level is strongly influenced by this small structural difference. The effective timescales for solvent migration triggered by ionization are mainly controlled by the efficiency of the kinetic energy redistribution rather than the shape of the potential energy surface. This approach provides a fundamental understanding of protein hydration and may help to design functional molecules in solution with tailored properties.
Irritable bowel syndrome (IBS) is a gut-brain disorder involving alterations in intestinal sensitivity and motility. Serotonin 5-HT4 receptors are promising candidates in IBS pathophysiology since they regulate gut motor function and stool consistency, and targeted 5-HT4R selective drug intervention has been proven beneficial in subgroups of patients. We identified a single nucleotide polymorphism (SNP) (rs201253747) c.*61 T > C within the 5-HT4 receptor gene \(HTR4\) to be predominantly present in diarrhoea-IBS patients (IBS-D). It affects a binding site for the miR-16 family and miR-103/miR-107 within the isoforms \({HTR4b/i}\) and putatively impairs \(HTR4\) expression. Subsequent miRNA profiling revealed downregulation of miR-16 and miR-103 in the jejunum of IBS-D patients correlating with symptoms. \(In\) \(vitro\) assays confirmed expression regulation via three 3′UTR binding sites. The novel isoform \(HTR4b\_2\) lacking two of the three miRNA binding sites escapes miR-16/103/107 regulationin SNP carriers. We provide the first evidence that \(HTR4\) expression is fine-tuned by miRNAs, and that this regulation is impaired either by the SNP c.*61 T > C or bydiminished levels of miR-16 and miR-103 suggesting that \(HTR4\) might be involved in the development of IBS-D.
Social life is organized around rules and norms. The present experiments investigate the cognitive architecture of rule violations. To do so, a setting with arbitrary rules that had to be followed or broken was developed, and breaking these rules did not have any negative consequences. Removed from any social influences that might further encourage or hinder the rule breaker, results suggest that simply labeling a behavior as a rule violation comes with specific costs: They are more difficult to plan and come with specific behavioral markers during execution. In essence, rule violations resemble rule negations, but they also trigger additional processes.
The question of what makes rule violations more difficult than rule inversions is the major focus of the remaining experiments. These experiments revealed negative affective consequences of rule violation and rule inversions alike, while rule violations additionally prime authority-related concepts, thus sensitizing towards authority related stimuli.
Next, the question how these burdens of non-conformity can be mitigated was investigated, and the influence of having executed the behavior in question frequently and recently was tested in both negations and rule violations. The burdens of non-conformity can best be reduced by a combination of having violated/negated a rule very frequently and very recently. Transfer from another task, however, could not be identified.
To conclude, a model that accounts for the data that is currently presented is proposed. As a variant of a task switching model, it describes the cognitive processes that were investigated and highlights unique processing steps that rule violations seem to require.
Driving simulators are powerful research tools. Countless simulator studies have contributed to traffic safety over the last decades. Constant improvements in simulator technology call for a measureable scale to assess driving simulators with regard to their utility in human factors research. A promising psychological construct to do so is presence. It is commonly defined as the feeling of being located in a remote or virtual environment that seems to be real. Another aspect of presence describes the ability to act there successfully.
The main aim of this thesis is to develop a presence model dedicated to the application in driving simulators. Established models have been combined and extended in order to gain a comprehensive model of presence that allows understanding its emergence and deriving recommendations on how to design or improve driving simulators. The five studies presented in this thesis investigate specific postulated model components and their interactions. All studies deal with motorcycling or a motorcycle riding simulator as exemplary field of application.
The first study used a speed estimation task to investigate the contribution of different sensory cues to presence. While visualization plays a particularly important role, further improvements could be achieved by adding more consistent sensory stimuli to the virtual environment. Auditory, proprioceptive and vestibular cues have been subject to investigation. In the second study, the speed production method was applied. It confirmed the positive contribution of action to presence as predicted by psychocybernetic models. The third study dealt with the effect of training on presence. Hence, no positive effect was observed. The fourth study aimed at replicating previous findings on sensory fidelity and diversity in a more complex riding situation than only longitudinal vehicle control. The riders had to cross an unexpectedly appearing deep pit with the virtual motorcycle. The contribution of more consistent sensory stimulation on presence was successfully shown in this scenario, too. The final study was a real riding experiment that delivered reference values for the speed estimation capabilities of motorcycle riders. Besides higher variations in the simulator data, the general speed estimation performance was on a comparable level. Different measures, such as subjective ratings, behavioral responses, performance, and physiological reactions, have been applied as presence indicators.
These studies’ findings deliver evidence for the meaningful application of the proposed presence model in driving simulator settings. The results suggest that presence can be interpreted as a quality measure for perception in virtual environments. In line with psychocybernetic models, taking action, which is seen as controlling perception, enhances this quality even further. Describing the psychological construct of presence in a theoretical framework that takes the diversity of perception and action in driving simulator settings into account closes a gap in traffic psychological research.
Background
40–50% of patients with colorectal cancer (CRC) will develop liver metastases (CRLM) during the course of the disease. One third of these patients will additionally develop pulmonary metastases.
Methods
137 consecutive patients with CRLM, were analyzed regarding survival data, clinical, histological data and treatment. Results were stratified according to the occurrence of pulmonary metastases and metastases resection.
Results
39% of all patients with liver resection due to CRLM developed additional lung metastases. 44% of these patients underwent subsequent pulmonary resection. Patients undergoing pulmonary metastasectomy showed a significantly better five-year survival compared to patients not qualified for curative resection (5-year survival 71.2% vs. 28.0%; p = 0.001). Interestingly, the 5-year survival of these patients was even superior to all patients with CRLM, who did not develop pulmonary metastases (77.5% vs. 63.5%; p = 0.015). Patients, whose pulmonary metastases were not resected, were more likely to redevelop liver metastases (50.0% vs 78.6%; p = 0.034). However, the rate of distant metastases did not differ between both groups (54.5 vs.53.6; p = 0.945).
Conclusion
The occurrence of colorectal lung metastases after curative liver resection does not impact patient survival if pulmonary metastasectomy is feasible. Those patients clearly benefit from repeated resections of the liver and the lung metastases.