From objectives to competencies: operationalizing the NONPF PMHNP competencies for use in a graduate curriculum.

In the summer of 2004, the faculty in the psychiatric mental health nurse practitioner (PMHNP) Program at Oregon Health and Science University School of Nursing began the redesign of an objective-based curriculum to a competency-based curriculum. The competencies were based on the 2003 National Organization of Nurse Practitioner Faculties (NONPF) PMHNP competencies. This article describes the background and rationale for the curriculum redesign, the transition process, our resulting set of curriculum competencies, associated learning strategies, and some of the barriers and benefits we encountered.

[Trials with a new potentially biodegradable ureteral stent. In vitro results with GX 100-15 LB].

We detected a special plastic, which is stable in an acid environment and dissolvable in a basic one. Our preliminary in-vitro results show that the tested material therefore seems principally designed for developing biodissolvable stents for temporary urinary diversion out of the upper urinary tract. Stableness and dissolution could be steered by manipulating the pH.

[Improved tumor stent for internal palliative urinary diversion].

The disadvantages of high flexible endoureteral stents (DJ) in case of tumorinduced extrinsic ureteral compression are due to an insufficient vertical stability of the used stents leading to stent-compression and consecutive hydro- or pyonephrosis. The new developed tumor-stent used in case of tumor-induced ureteral compression is available from 6 to 8 French in diameter and 24 to 32 cm in length. The corpus consists of a combination of high-stability plastics but is of sufficient elasticity in length.

In vitro results with special plastics for biodegradable endoureteral stents.

Internal ureteral stents are widely used in urologic practice for temporary urinary diversion, but all double-J catheters to date exhibit the same disadvantage; that is, they have to be removed endoscopically, necessitating further intervention. We tested different materials (designated G100X-15xLB and G100X-20xLB) to develop a biodegradable (biodissolvable) endoureteral stent that can be held in place without functional loss yet could be dissolved by changing the environment. The principle of the biochemical background is based on the physiological milieu of the urine.

New endoureteral double-J stent resists extrinsic ureteral compression.

The disadvantages of highly flexible endoureteral (double J) stents in the face of tumor-induced extrinsic ureteral compression are a consequence of insufficient cross-sectional stability, leading to stent compression and thus to hydronephrosis or pyonephrosis. The newly developed tumor stent, which is used in cases of tumor-induced ureteral compression, is available in sizes from 6F to 8F in diameter and 24 to 32 cm in length. The shaft consists of a combination of high-stability plastics that presents sufficient elasticity in length.

Potentially useful materials for biodegradable ureteric stents.

Objectives: To develop and test materials that may be useful in the design and further development of biodegradable ureteric stents.

Materials And Methods: Specimens of two plastics were placed in artificial urine of different pH for 30 days to examine the degree of dissolution of the plastic in alkaline and the stability in acidic conditions.

Results: The specimens remained stable in the artificial urine at pH < 7.

[Modulith SL 20. One-year urologic experience with a lithotripter of the third generation].

The MODULITH SL20 combines on-line ultrasound and optional X-ray in series. In addition to highly simplified patient positioning and the possibility of handling the machine as a multipurpose lithotripter for disintegration of urinary-, gallbladder and bile duct stones and for treatment of pancreatic concrements this appliance can be used in cases of sialolithiasis and as a workplace for all urological purposes, so that the design is very modern. As the energy level in f2 can be extremely high, a disintegration rate of about was achieved for 70% ureteral stones in the middle and distal sections of the ureter.

Efficacy, risks, and limits of extracorporeal shock wave lithotripsy for salivary gland stones.

Stones of the salivary glands may cause recurrent swelling, ascending inflammation, and colic-like pain. Previously, in order to get rid of these stones, the gland usually had to be removed surgically in spite of the associated risks to adjacent structures, especially the facial nerve. We treated 104 salivary gland stones in patients 14 to 78 years old using the Storz Modulith SL 10 lithotripter.

Effects of magnesium citrate and phytin on reducing urinary calcium excretion in rats.

The aim of this study was to determine and compare the effects of both magnesium citrate and phytin on reducing urinary calcium excretion under high-calcium-diet conditions during single and combined treatments. An animal experiment was carried out over a period of 4 weeks in 35 male rats. Urinary calcium excretion was reduced significantly by magnesium citrate and/or phytin in rats fed on high-calcium diets.

Orchitis following mumps vaccination in an adult.

An acute epididymo-orchitis, followed by a viral arthritis of the left hand, occurred as complications of a mumps vaccination. In the last 17 years 4 certain cases of orchitis following vaccination have been published in Germany. We describe an additional case and discuss the possible consequences.

[The therapeutic value of ambulatory extracorporeal shockwave lithotripsy of salivary calculi. Results of a prospective study].

In a prospective study, results of the extracorporeal shock wave lithotripsy of salivary stones were evaluated. The study was performed with the currently available technical possibilities of electromagnetic systems to get indication criteria for this procedure. Using the Modulith SL 20-lithotripter of Storz Medical AG, 33 concrements in 25 patients were treated in 89 lithotripsy sections.

[ESWL in hemophilia B].

One of the most dramatic dangers in treating nephrolithiasis by ESWL is the development of intra- and perirenal bleeding, which requires therapeutic intervention. Even in patients whose blood parameters suggest they are healthy, hematomas are found in up to 80%. Therefore, ESWL must be regarded as contraindicated in patients with blood disorders.

Metastatic renal cell carcinoma (RCC): spontaneous regression, long-term survival and late recurrence.

We report 4 cases of metastatic renal cell carcinoma (RCC) with long-term survival either following radical nephrectomy alone or in combination with radio- or hormonal therapy. Two patients with lymph node metastases showed a long-term survival of 12 or more years following radical tumour nephrectomy (with lymphadenectomy) and radiotherapy. One of them exhibited a histologically proven tumour recurrence nearly 12 years after primary surgical treatment and died shortly later; the other one is still without any evidence of metastatic disease.

In vitro sensitivity testing of human renal cell carcinoma with cytostatic agents and interferon alpha-2a.

Samples of 38 human renal cell carcinomas (RCC) were subjected to routine histopathological examination but also to in vitro sensitivity testing with mitomycin C, vinblastine and interferon Alpha-2a at various concentrations corresponding to serum titers recommended to be effective in vivo, employing a monolayer assay. Extending earlier in vitro studies, both tumor cell kill rates (TCKR) and proliferation rates (PR) were assessed. Following in vitro preparation the tumor cell cultures were simultaneously exposed to the anticancer drugs listed above.

Antiproliferative activity of picolinic acid due to macrophage activation.

Activation and subsequent enhancement of cytotoxicity of mouse peritoneal macrophages (M phi) by picolinic acid (PLA) in vivo have been reported previously by the authors' group. The optimum dose was found to be 100 mg/kg. PLA-stimulated M phi lysed different tumor targets in vitro, MBL-2 lymphoma cells and Madison 109 lung carcinoma cells, with equal efficiency.