Insignificant prostate cancer and active surveillance: from definition to clinical implications.

Context: Due to early detection strategies, prostate cancer is diagnosed early in its natural history. It remains unclear whether all patients diagnosed with prostate cancer warrant radical treatment or may benefit from delayed intervention following active surveillance.

Objective: A systematic review of active surveillance protocols to investigate the inclusion criteria for active surveillance and the outcome of treatment.

Upper transverse scrotal approach for muscle- and nerve-sparing urethral stricture repair.

Objective: Open surgery on bulbar urethral strictures has become a widespread procedure. While there is inconsistency which procedure to perform at the bulbar region, there is consistency of the used incisional approach despite of several potential disadvantages. Therefore, to bypass disadvantages, we performed an upper transverse scrotal approach for stricture repair in the pendulous urethra and the distal bulbar urethra as previously reported for the placement of an artificial urinary sphincter.

Quality of life and perioperative outcomes after retroperitoneoscopic radical nephrectomy (RN), open RN and nephron-sparing surgery in patients with renal cell carcinoma.

Objective: To prospectively evaluate health-related quality of life (HRQoL) and perioperative outcomes in patients with T1 and T2 renal cell carcinoma (RCC) after retroperitoneoscopic radical nephrectomy (RRN), open RN (ORN) or open nephron-sparing surgery (NSS).

Patients And Methods: The data of 117 patients who had undergone RRN (36), ORN (37) or NSS (44) were evaluated. RRN data were obtained at Basel University Hospital, Switzerland, while the ORN and NSS data were collected at the University of Munich, Germany.

Prospective single-centre comparison of 120-W diode-pumped solid-state high-intensity system laser vaporization of the prostate and 200-W high-intensive diode-laser ablation of the prostate for treating benign prostatic hyperplasia.

Objective: To evaluate the safety, efficacy and short-term outcome of a new 980 nm high-intensity diode (HiDi) laser (Limmer Laser, Berlin, Germany) system in comparison to the diode-pumped solid-state laser high-performance system (HPS; GreenLight(TM), AMS, Minnetonka, MI, USA) for treating benign prostatic hyperplasia (BPH) in a prospective non-randomized single-centre study.

Patients And Methods: From February to September 2007, 117 consecutive patients with lower urinary tract symptoms secondary to BPH were included; 62 patients were treated with 120-W HPS laser vaporization and 55 with 980-nm HiDi laser ablation of the prostate. We evaluated perioperative variables, and complications during and after surgery.

Functional magnetic resonance imaging in prostate cancer.

Context: Magnetic resonance imaging (MRI) combined with magnetic resonance spectroscopy imaging (MRSI), dynamic contrast-enhanced MRI, and diffusion-weighted MRI emerged as promising tests in the diagnosis of prostate cancer, and they show encouraging results.

Objective: This review emphasizes different functional MRI techniques in the diagnosis of prostate cancer and includes information about their clinical value and usefulness.

Evidence Acquisition: The authors searched the Medline, Embase, and Cochrane Library databases.

Laser therapy for upper urinary tract transitional cell carcinoma: indications and management.

Context: Ureteroscopically guided laser techniques are commonly used in the treatment of upper urinary tract transitional cell carcinoma (UUTT); however, there is an ongoing debate with regard to indication and management.

Objective: To review the indication, feasibility, and treatment outcome of laser application for definitive endoscopic treatment of UUTT, focusing on technical aspects of different laser devices and their impact on tissue.

Evidence Acquisition: PubMed and Medline were searched for reports on laser therapy in UUTT from 1980 to 2008, with particular focus on the technical background of various laser systems.

PR3-ANCA-positive necrotizing multi-organ vasculitis following cocaine abuse.

A 22-year-old man with a history of cocaine abuse from 2003 to 2005 developed recurrent bleeding of the nasal septum and a progressive cough and dyspnoea. He was admitted to the intensive care unit because of fulminant pneumonia, impaired renal function and progressive general deterioration. While hospitalized, he developed cutaneous vasculitis, thrombosis of the right subclavian and right jugular veins, testicular pain and, eventually, expanding red papules and plaques on the limbs.

How to deal with weak interactions in noncovalent complexes analyzed by electrospray mass spectrometry: cyclopeptidic inhibitors of the nuclear receptor coactivator 1-STAT6.

Mass spectrometry, and especially electrospray ionization, is now an efficient tool to study noncovalent interactions between proteins and inhibitors. It is used here to study the interaction of some weak inhibitors with the NCoA-1/STAT6 protein with K(D) values in the microM range. High signal intensities corresponding to some nonspecific electrostatic interactions between NCoA-1 and the oppositely charged inhibitors were observed by nanoelectrospray mass spectrometry, due to the use of high ligand concentrations.

Preliminary evaluation of a novel side-fire diode laser emitting light at 940 nm, for the potential treatment of benign prostatic hyperplasia: ex-vivo and in-vivo investigations.

Objectives: To evaluate, ex vivo and in vivo, the tissue-removal capacity and coagulation properties of a diode laser emitting light at 940 nm, as in the search for potential therapeutic strategies for benign prostatic hyperplasia that cause less morbidity than transurethral resection of the prostate (TURP), various types of lasers have been tested.

Materials And Methods: A diode laser system (prototype; wavelength 940 nm, Dornier MedTech, Wessling, Germany) was evaluated in an isolated, blood-perfused ex-vivo porcine kidney model at 10-60 W (five kidneys). An in-vivo beagle model was used to investigate the effects on six prostate lobes at a generator output power level of 200 W.

Explosive gas formation during transurethral resection of the prostate (TURP).

Intravesical explosion during transurethral resection of the prostate (TURP) is an extremely rare event. It might be associated with various degrees of bladder injury ranging from simple mucosal tear to rupture of the bladder. It is believed that intravesical explosion occurs due to formation of explosive gases in the bladder during TURP and its admixture with air.

Congenital intrarenal arteriovenous malformation presenting with gross hematuria after endoscopic intervention: a case report.

Introduction: Although diagnostic ureterorenoscopy is a minimally invasive and effective diagnostic procedure, it has the potential for significant postoperative complications. We report the first case in the literature of intrarenal arteriovenous fistulas causing hemodynamic effective anemia 4 days after ureterorenoscopic biopsy.

Case Presentation: A 63-year-old Caucasian woman presented with hemodynamic effective macrohematuria (hemoglobin 70 g/liter) 4 days after ureterorenoscopy and biopsy of the upper pole collecting system due to recurrent microhematuria.

Ludwig II, King of Bavaria: a royal medical history.

Objective: The case of Ludwig II, King of Bavaria, had soon become synonymous with paranoia, after he had drowned at the age of 40 together with the neuropsychiatrist Gudden.

Method: We were granted access to the Secret Archive of the House of Wittelsbach to study documents on Ludwig's medical history.

Results: The documents underlying Gudden's expert opinion which led to Ludwig being deposed would be insufficient for a diagnosis of schizophrenia according to contemporary standards.

Highly fluorescent group 13 metal complexes with cyclic, aromatic hydroxamic acid ligands.

The neutral complexes of two ligands based on the 1-oxo-2-hydroxy-isoquinoline motif with group 13 metals (Al, Ga, In) show bright blue-violet luminescence in organic solvents. The corresponding transition can be attributed to ligand-centered singlet emission, characterized by a small Stokes shifts of only a few nanometers combined with lifetimes in the range between 1 and 3 ns. The fluorescence efficiency is high, with quantum yields of up to 37% in benzene solution.

Use of YbIII-centered near-infrared (NIR) luminescence to determine the hydration state of a 3,2-HOPO-based MRI contrast agent.

The synthesis, structure, and characterization of a [Yb(Tren-Me-3,2-HOPO)(H 2O) 2] complex are reported. As a result of its Yb (III) emission in the near-infrared region, sensitized by the Me-3,2-HOPO chromophore, this complex can be utilized for the first time to determine the hydration state, q, via the luminescence lifetimes and hence the solution structure of these Me-3,2-HOPO-type ligands, which have attracted significant interest in complex with Gd (III) as possible next-generation magnetic resonance imaging contrast agents.

Ex vivo and in vivo investigations of the novel 1,470 nm diode laser for potential treatment of benign prostatic enlargement.

Perioperative haemorrhage is still the major complication of transurethral resection of the prostate (TURP) for benign enlargement of the prostate. Photoselective vaporisation of the prostate (PVP) with the potassium-titanyl-phosphate (KTP) laser has been shown to achieve instant tissue ablation with excellent haemostatic properties. Our aim was to determine the tissue removal capacity, coagulation and haemostatic property of the novel 1,470 nm diode laser, ex vivo and in vivo.

Comparison of potassium-titanyl-phosphate laser vaporization of the prostate and transurethral resection of the prostate: update of a prospective non-randomized two-centre study.

Objectives: To evaluate the intermediate-term clinical efficacy and the rate of complications in 80 W photoselective vaporization of the prostate (PVP) with the potassium-titanyl-phosphate laser (Greenlight, (AMS, Minnetonka, MN, USA) compared with transurethral resection of the prostate (TURP) in a prospective non-randomised two-centre study.

Patients And Methods: From December 2003 to August 2006, 396 patients (PVP 269, TURP 127) with lower urinary tract symptoms secondary to benign prostatic hyperplasia were included in the study. There was a significant difference in mean age (72 years for PVP vs 68 for TURP, P = 0.

[Sjögren's syndrome].

The leading symptoms of this autoimmune disease are xerostomia and xerophthalmia. Both are characterised by a lymphoplasmacellular destructive inflammation of salivary and lacrimal glands and the detection of autoantibodies against Ro/SS-A and La/SS-B nuclear antigens. In the long run of the disease, a polyclonal hypergammaglobulinemia is evolving as a consequence of chronic B-cell stimulation which can also lead to B-cell lymphoma which underlines the need for periodical clinical and laboratory examinations.

[Organ-sparing surgery for penile cancer].

In patients with penile cancer health-related quality of life is closely related to organ-sparing surgery. To achieve an ideally suited treatment modality for this rare but aggressive tumor entity different operating techniques like micrographic surgery, laser treatment, and glansectomy were developed. These should offer optimal oncological treatment while preserving sexual function.

Morbidity, mortality and early outcome of transurethral resection of the prostate: a prospective multicenter evaluation of 10,654 patients.

Purpose: Transurethral resection of the prostate has for decades been the standard surgical therapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia, the most common benign neoplasm in men. To generate a contemporary reference for evolving medical and minimally invasive therapies we analyzed complications and immediate outcomes of transurethral prostate resection in a statewide multicenter study.

Materials And Methods: We prospectively evaluated 10,654 patients undergoing transurethral prostate resection in the state of Bavaria, Germany from January 1, 2002 until December 31, 2003.

GreenLight laser vaporization of the prostate: single-center experience and long-term results after 500 procedures.

Background: Long-term data of photoselective vaporization of the prostate (PVP) for treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) is scanty.

Objective: Evaluate the long-term efficacy and the complication rate in 80-watt (W) PVP.

Design, Setting, And Participants: 500 consecutive patients with LUTS secondary to BPH underwent PVP between September 2002 and April 2007.