Standardization of definitions in focal therapy of prostate cancer: report from a Delphi consensus project

Purpose: To reach standardized terminology in focal therapy (FT) for prostate cancer (PCa). Methods: A four-stage modified Delphi consensus project was undertaken among a panel of international experts in the field of FT for PCa. Data on terminology in FT was collected from the panel by three rounds of online questionnaires. During a face-to-face meeting on June 21, 2015, attended by 38 experts, all data from the online rounds were reviewed and recommendations for definitions were formulated. Results: Consensus was attained on 23 of 27 topics; Targeted FT was defined as a lesion-based treatment strategy, treating all identified significant cancer foci; FT was generically defined as an anatomy-based (zonal) treatment strategy. Treatment failure due to the ablative energy inadequately destroying treated tissue is defined as ablation failure. In targeting failure the energy is not adequately applied to the tumor spatially and selection failure occurs when a patient was wrongfully selected for FT. No definition of biochemical recurrence can be recommended based on the current data. Important definitions for outcome measures are potency (minimum IIEF-5 score of 21), incontinence (new need for pads or leakage) and deterioration in urinary function (increase in IPSS >5 points). No agreement on the best quality of life tool was established, but UCLA-EPIC and EORTC-QLQ-30 were most commonly supported by the experts. A complete overview of statements is presented in the text. Conclusion: Focal therapy is an emerging field of PCa therapeutics. Standardization of definitions helps to create comparable research results and facilitate clear communication in clinical practice

Falsche Erinnerungen

Kühnel S, Markowitsch HJ. Falsche Erinnerungen. In: A S, F W, eds. Schaltstelle Gehirn: Denken, Erkennen, Handeln. Heidelberg: Spektrum; 2008: 50-76

Self-assembly of Discotic Liquid Crystals in Nanopores as Seen by X-Ray Diffraction and Monte Carlo Computer Simulation

Discotic liquid crystals (DLCs), often driven by the π--π interactions among their aromatic cores, may self-organize and stack up in columns, leading to a hexagonal ordered columnar liquid crystalline mesophase

Mesoporous Alumina- and Silica-Based Crystalline Nanocomposites with Tailored Anisotropy: Methodology, Structure and Properties

We present several recently synthesized nanocomposites consisting of liquid crystals as well as an organic molecular crystal embedded into the nanochannels of mesoporous alumina and silica. As liquid-crystalline mesogens achiral, nematogen and chiral cholesteric guest molecules infiltrated into nanochannels by spontaneous imbibition were chosen. The molecular ordering inside the nanochannels, which can be tailored by modifying the surface anchoring, was characterized by optical polarimetry (linear and/or circular birefringence) in combination with X-ray diffraction. For the synthesis of the solid crystalline nanocomposites ferroelectric triglycine sulfate (TGS) nanocrystals were deposited into the nanochannels by slow evaporation of saturated water solutions imbibed into the porous hosts. Their textural and physicochemical properties were explored by x-ray diffraction, scanning electron microscopy and dielectric techniques

Unsupervised Learning Model for Registration of Multi-phase Ultra-Widefield Fluorescein Angiography

Registration methods based on unsupervised deep learning have achieved good performances, but are often ineffective on the registration of inhomogeneous images containing large displacements. In this paper, we propose an unsupervised learning-based registration method that effectively aligns multi-phase Ultra-Widefield (UWF) fluorescein angiography (FA) retinal images acquired over the time after a contrast agent is applied to the eye. The proposed method consists of an encoder-decoder style network for predicting displacements and spatial transformers to create moved images using the predicted displacements. Unlike existing methods, we transform the moving image as well as its vesselness map through the spatial transformers, and then compute the loss by comparing them with the target image and the corresponding maps. To effectively predict large displacements, displacement maps are estimated at multiple levels of a decoder and the losses computed from the maps are used in optimization. For evaluation, experiments were performed on 64 pairs of early- and late-phase UWF retinal images. Experimental results show that the proposed method outperforms the existing methods. © 2020, Springer Nature Switzerland AG

Focal therapy for small renal masses. Observation, ablation or surgery

The rising incidence of renal cell carcinoma, its more frequent early detection (stage T1a) and the increasing prevalence of chronic renal failure with higher morbidity and shorter life expectancy underscore the need for multimodal focal nephron-sparing therapy. During the past decade, the gold standard shifted from radical to partial nephrectomy. Depending on the surgeon's experience, the patient's constitution and the tumor's location, the intervention can be performed laparoscopically with the corresponding advantages of lower invasiveness. A treatment alternative can be advantageous for selected patients with high morbidity and/or an increased risk of complications associated with anesthesia or surgery. Corresponding risk stratification necessitates previous confirmation of the small renal mass (cT1a) by histological examination of biopsy samples. Active surveillance represents a controlled delay in the initiation of treatment. Percutaneous radiofrequency ablation (RFA) and laparoscopic cryoablation are currently the most common treatment alternatives, although there are limitations particularly for renal tumors located centrally near the hilum. More recent ablation procedures such as high intensity focused ultrasound (HIFU), irreversible electroporation, microwave ablation, percutaneous stereotactic ablative radiotherapy and high-dose brachytherapy have high potential in some cases but are currently regarded as experimental for the treatment of renal cell carcinoma