PET imaging of the impact of extracellular pH and MAP kinases on the p-glycoprotein (Pgp) activity.

The functional activity of p-glycoprotein (Pgp) can be increased in vitro by an extracellular acidosis via activation of MAP kinases (p38, ERK1/2). In order to study these effects in vivo a new (68)Ga-labeled PET tracer was developed which serves as a substrate of the Pgp and therefore indirectly mirrors the Pgp activity. For in vivo studies, experimental tumors were imaged under acidic conditions (inspiratory hypoxia, injection of lactic acid) and during inhibition of MAP kinases in a μ-PET system.

Assessing p-glycoprotein (Pgp) activity in vivo utilizing 68Ga-Schiff base complexes.

Purpose: The p-glycoprotein (Pgp) is the most prominent member of active drug transporters leading to a multidrug-resistant phenotype. For identification of tumors functionally overexpressing Pgp in vivo, non-invasive imaging techniques are needed.

Procedures: Six Schiff base compounds were synthesized and labeled with (68)Ge/(68)Ga generator-derived (68)Ga.

Activation of P-glycoprotein (Pgp)-mediated drug efflux by extracellular acidosis: in vivo imaging with 68Ga-labelled PET tracer.

Purpose: In vitro it has been shown that the functional activity of P-glycoprotein (Pgp), an important drug transporter responsible for multidrug resistance, can be strongly increased by extracellular acidosis. Here mitogen-activated protein kinases (MAPK) (p38, ERK1/2) seem to play an important role for signal transduction. However, it is unclear whether these effects are also relevant in vivo.

Laparoscopic radical prostatectomy in men older than 70 years of age with localized prostate cancer: comparison of morbidity, reconvalescence, and short-term clinical outcomes between younger and older men.

Objectives: To analyze the safety and efficacy of extraperitoneal laparoscopic radical prostatectomy (eL-RPE) in elderly versus younger men with localized prostate cancer.

Methods: Patients undergoing eL-RPE were retrospectively subdivided into group eL-RPE1 (72 men aged 71 yr and older) and group eL-RPE2 (132 men aged 59 yr and younger). Group eL-RPE1 was compared with a group of 70 contemporary, comparable patients aged 71 yr and older undergoing open retropubic radical prostatectomy (group OPEN-RPE).

Vesicourethral anastomosis during endoscopic extraperitoneal radical prostatectomy: a prospective comparison between the single-knot running and interrupted technique.

Objectives: To determine the safety and efficacy of the single-knot running versus interrupted technique for urethrovesical anastomosis during endoscopic extraperitoneal radical prostatectomy.

Methods: A total of 250 consecutive patients who underwent endoscopic extraperitoneal radical prostatectomy were prospectively divided into two groups of 125 patients each who underwent urethrovesical anastomosis using the single-knot running technique (group 1) or the interrupted suture technique (group 2). Surgical data, operative time, difficulty scores, extravasation rate, catheterization time, occurrence of anastomotic strictures, and the early and late continence rates were analyzed statistically.

Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study.

Objectives: To compare the postoperative quality of life (QOL) and reconvalescence in patients with clinical Stage I nonseminomatous germ cell tumor (NSGCT) after laparoscopic retroperitoneal lymph node dissection (L-RPLND) and the open procedure (O-RPLND).

Methods: Twenty-one patients with NSGCT who underwent transperitoneal L-RPLND were matched and compared with 29 patients who underwent O-RPLND. The operative, QOL, and recovery data and complications and cure rates were analyzed for both groups.

Laparoscopic radical prostatectomy: impact of modified apical and posterolateral dissection in reduction of positive surgical margins in patients with clinical stage T2 prostate cancer and high risk of extracapsular extension.

Purpose: To determine whether modifications of extraperitoneal endoscopic radical prostatectomy (EERP) reduce the rate of a positive surgical margin (PSM) in men with clinical stage T(2) prostate cancer and a high risk of extracapsular extension.

Patients And Methods: A consecutive series of 182 men with stage cT(2) tumors and a high risk of extracapsular extension underwent EERP by a single surgeon (VP). The patients were divided into two groups: 71 patients who underwent a standard EERP (group 1) and 111 patients who underwent EERP with the modified technique (group 2).

Extracorporeal shockwave therapy for Peyronie's disease: an alternative treatment?

Aim: To determine retrospectively the safety and efficacy of extracorporeal shock wave therapy (ESWT) in patients with Peyronie's disease.

Methods: Fifty-three patients with stable Peyronie's disease underwent ESWT (group 1). Fifteen patients matched with the baseline characteristic of the patients in group 1, who received no treatment, were used as the control (group 2).

Intensive laparoscopic training: the impact of a simplified pelvic-trainer model for the urethrovesical anastomosis on the learning curve.

We prospectively evaluated the learning curve (LC) for laparoscopic urethrovesical anastomosis (L-UVA) in an operator-training model and program using an innovative simplified pelvic-trainer model. Over a period of 12 months, 30 LRP were performed by one urologist skilled in open surgery but inexperienced in laparoscopy. During the first 15 procedures no systematic training was done.

Laparoscopic radical prostatectomy using an extraperitoneal approach: Nordwest hospital technique and initial experience in 255 cases.

Purpose: We report on our modifications in technique and initial experience with 255 extraperitoneal laparoscopic radical prostatectomy (eLRP).

Patients And Methods: Using significant surgical modifications, our laparoscopic method replicates the steps of the retropubic descending RP. We evaluated 255 consecutive patients who underwent an eLRP with pelvic lymph-node dissection.

Tension-free vaginal tape (TVT) in morbidly obese patients with severe urodynamic stress incontinence as last option treatment.

Objectives: To determine the safety and efficacy of tension-free vaginal tape (TVT) in morbidly obese women with severe urodynamic stress incontinence (USI) as last option treatment.

Methods: Thirty-one patients with body mass index (BMI) >40 kg/m2, who had undergone the TVT procedure for urodynamically-confirmed USI were matched with 52 patients with BMI <30 kg/m2 who underwent the same procedure. BMI was calculated at the time of the surgery.

Retroperitoneoscopic versus open surgical radical nephrectomy for large renal cell carcinoma in clinical stage cT2 or cT3a: quality of life, pain and reconvalescence.

Objectives: To determine whether retroperitoneoscopic radical nephrectomy for large renal cell carcinoma in stage cT2 or cT3a is a feasible, safe and effective therapy option and if it shows any advantage regarding quality of life in comparison to open procedure.

Methods: 23 patients who underwent RPNx for tumor size greater than 7 cm (group 1) were matched and compared with 25 patients, who underwent ONx (group 2) for tumor with similar size characteristics. Patient and surgical data, QoL variables and complications were statistically analyzed.

Laparoscopic radical prostatectomy: the value of intraoperative frozen sections.

Objective: To examine the clinical and pathological value of intraoperative frozen section (IFS) in patients undergoing laparoscopic radical prostatectomy (L-RPE) for clinically localized prostate cancer.

Methods: The study includes 198 consecutive cases of L-RPE. After removal of the prostate, a 2-3mm circumferential specimen was obtained from the apical and bladder neck soft-tissue margin and submitted for IFS examination.

Laparoscopic radical prostatectomy: prospective evaluation of the learning curve.

Objective: We prospectively evaluated the learning curve (LC) of laparoscopic radical prostatectomy (L-RPE) regarding the improvements in operative times (OT) and technical difficulty in one-operator-practice as it compares with open RPE.

Methods: Over 18 months, 50 L-RPE were performed by an inexperienced surgeon in laparoscopy but skilled in open surgery. Difficulty scores were obtained at the completion of each L-RPE comparing L-RPE to open RPE.

Synthesis and preliminary evaluation of (R,R)(S,S) 5-(2-(2-[4-(2-[(18)F]fluoroethoxy)phenyl]-1-methylethylamino)-1-hydroxyethyl)-benzene-1,3-diol ([(18)F]FEFE) for the in vivo visualisation and quantification of the beta2-adrenergic receptor status in lung.

The (18)F-labeled beta2-adrenergic receptor ligand (R,R)(S,S) 5-(2-(2-[4-(2-[(18)F]fluoroethoxy)phenyl]-1-methylethylamino)-1-hydroxyethyl)-benzene-1,3-diol, a derivative of the original highly selective racemic fenoterol, was synthesized in an overall radiochemical yield of 20% after 65 min with a radiochemical purity higher than 98%. The specific activity was in the range of 50-60 GBq/micromol. In vitro testing of the non-radioactive fluorinated fenoterol derivative with isolated guinea pig trachea was conducted to obtain an IC(50) value of 60 nM.