Dichte Objektsegmentierung in Stereobildfolgen

Die in dieser Arbeit vorgestellte Szenensegmentierung zerlegt eine Stereobildsequenz in eine Menge von Bildbereichen, die vom Menschen eindeutig als unabhängig bewegte Verkehrsobjekte interpretierbar sind. Eine Besonderheit des Verfahrens ist die Tatsache, dass die einzelnen Teilaufgaben der dreidimensionalen Rekonstruktion, Bewegungsschätzung und Segmentierung dabei in einem gemeinsamen Modell beschrieben und in verzahnter Reihenfolge gelöst werden

Complications of laser prostatectomy: a review of recent data

Introduction: Laser techniques for the treatment of bladder outlet obstruction (BOO) due to benign prostate enlargement (BPE) have emerged as an alternative to transurethral resection of the prostate (TURP) and open prostatectomy (OP). Materials and methods: A Medline search over the past 4years was performed to assess the safety, intra- and postoperative morbidity of various laser techniques. Results: Data on holmium laser enucleation of the prostate (HoLEP) show the highest grade of evidence with two meta-analyses available and prove the low intra- and postoperative morbidity with reproducible long-term results. Photoselective vaporization of the prostate (PVP) with the Greenlightlaser (potassium titanyl phosphate, KTP or lithium borate, LBO) is characterized by excellent haemostatic properties in patients with or without oral anticoagulation. Long-term results show a reoperation rate comparable with TURP; however, there is a lack of randomized trials. Various types of diode lasers with different wavelengths are available for laser vaporization; despite their favourable haemostatic properties, a higher invasion depth seems to result in necrosis of the tissue leading to a higher rate of reoperation. Thulium-laser resection of the prostate shows promising intra- and postoperative morbidity, but data are limited and initial results need to be confirmed in large-scale trials. Conclusion: In summary, HoLEP- and KTP-, or LBO-laser vaporization of the prostate are the most mature techniques of laser prostatectomy and treatment alternatives to TURP and OP, whereas the clinical value and durability of procedures with diode laser systems and the thulium laser need to be confirmed in high-quality prospective RCT

Transcriptional activity of Pseudomonas aeruginosa fhp promoter is dependent on two regulators in addition to FhpR

The regulation of flavohemoglobin expression is complex and depending on its host organism requires a wide variety of different transcriptional regulators. In Pseudomonas aeruginosa, the flavohemoglobin (Fhp) and its cognate regulator FhpR form an NO-sensing and detoxifying system regulated by their common bidirectional promoter P fhp/P fhpR. The intergenic fhp-fhpR region of P. aeruginosa PAO1 was used as a bait to isolate proteins affecting the transcription of fhp and fhpR. In addition to the FhpR, we identified two previously uncharacterized P. aeruginosa proteins, PA0779 and PA3697. Both PA0779 and PA3697 were found to be essential for NO3 − and NO2 − induced P fhp activity under aerobic and low-oxygen conditions, and needed for the full function of P fhp/P fhpR as NO responsive regulatory circuit under aerobic conditions. In addition, we show that the transcriptional activity of P fhpR is highly inducible upon addition of SNP under aerobic conditions, but not by NO3 −, NO2 − or under low-oxygen conditions, supporting the findings that FhpR is not the only factor affecting flavohemoglobin expression in P. aeruginos

Annexin A1 exerts renoprotective effects in experimental crescentic glomerulonephritis

Non-resolving inflammation plays a critical role during the transition from renal injury towards end-stage renal disease. The glucocorticoid-inducible protein annexin A1 has been shown to function as key regulator in the resolution phase of inflammation, but its role in immune-mediated crescentic glomerulonephritis has not been studied so far. Methods: Acute crescentic glomerulonephritis was induced in annexin A1-deficient and wildtype mice using a sheep serum against rat glomerular basement membrane constituents. Animals were sacrificed at d5 and d10 after nephritis induction. Renal leukocyte abundance was studied by immunofluorescence and flow cytometry. Alterations in gene expression were determined by RNA-Seq and gene ontology analysis. Renal levels of eicosanoids and related lipid products were measured using lipid mass spectrometry. Results: Histological analysis revealed an increased number of sclerotic glomeruli and aggravated tubulointerstitial damage in the kidneys of annexin A1-deficient mice compared to the wildtype controls. Flow cytometry analysis confirmed an increased number of CD45 + leukocytes and neutrophil granulocytes in the absence of annexin A1. Lipid mass spectrometry showed elevated levels of prostaglandins PGE2 and PGD2 and reduced levels of antiinflammatory epoxydocosapentaenoic acid regioisomers. RNA-Seq with subsequent gene ontology analysis revealed induction of gene products related to leukocyte activation and chemotaxis as well as regulation of cytokine production and secretion. Conclusion: Intrinsic annexin A1 reduces proinflammatory signals and infiltration of neutrophil granulocytes and thereby protects the kidney during crescentic glomerulonephritis. The annexin A1 signaling cascade may therefore provide novel targets for the treatment of inflammatory kidney disease

Dismembered and non-dismembered retroperitoneoscopic pyeloplasty for the treatment of ureteropelvic junction obstruction in children

Purpose: Open dismembered pyeloplasty according to Anderson-Hynes (AHP) is the gold standard treatment for ureteropelvic junction obstruction in children. However, during the last decade, the management has been revolutionized with introduction of laparoscopy and endourology yielding comparable results and less morbid outcomes. Methods: Between 1997 and 2010, dismembered and non-dismembered retroperitoneoscopic pyeloplasty was performed in 41 children with a median age of 130month (range 5-192). 20 children underwent a dismembered pyeloplasty (Anderson-Hynes) and 21 children were operated by a non-dismembered pyeloplasty (Y-V-Plasty). Results: The mean operation time was 120min (range 52-257). Intraoperative findings revealed in 29 cases a significant crossing vessel. Based on a furosemide nephrogram and subjective complaints, the success rate was 88% with a median follow-up of 69month (range 14-142). The 5 failures (2 Y-V-Plasty, 3 AHP) have been treated by open AHP (n=2), Laser endopyelotomy (n=2) and Lap-AHP (n=1) without further problems. Conclusion: With increasing improvement of the suture techniques, the laparoscopic pyeloplasty represents in experienced hands an alternative method with comparable success rates to the open technique. In our opinion, retroperitoneoscopic pyeloplasty is technically possible and feasible even in infants. We found in our series no statistically significant difference between dismembered and non-dismembered pyeloplast

Microbial colonization and ureteral stent-associated storage lower urinary tract symptoms: the forgotten piece of the puzzle?

Purpose: Ureteral stents are frequently associated with side effects. Most patients suffer from storage lower urinary tract symptoms (LUTS). Storage LUTS are commonly attributed to the irritation of the trigone, smooth muscle spasm or a combination of factors. The relationship between microbial ureteral stent colonization (MUSC) and de novo or worsening storage LUTS has not been investigated yet. Methods: Five hundred ninety-one polyurethane ureteral stents from 275 male and 153 female patients were prospectively evaluated. The removed stents were sonicated to dislodge adherent microorganisms. Urine flow cytometry was performed to detect pyuria. A standardized urinary symptom questionnaire was given to all patients. Results: Thirty-five per cent of male and 28% of female cases showed de novo or worsened storage LUTS. MUSC was more common in patients with storage LUTS compared to patients without storage LUTS (men: 26 vs. 13%, respectively, P<0.05; women: 63 vs. 48%, respectively, P=0.13). Pyuria was significantly more common in patients with storage LUTS compared to patients without storage LUTS (men: 55 vs. 40%, respectively, P<0.05; women: 70 vs. 45%, respectively, P<0.05). No significant correlation was observed between the detected genera of microorganisms and storage LUTS. Conclusions: Our data show a significant association between MUSC- and stent-related de novo experienced or worsened storage LUTS in men. The incidence of MUSC is most common in both female and male patients with storage LUTS and accompanying pyuria. In these patients, a combination of antibiotics and anti-inflammatory drugs may be regarded as treatment optio

Complications of retroperitoneoscopic living donor nephrectomy: single center experience after 164 cases

Objectives: Retroperitoneoscopic living donor nephrectomy (RLDN) is used by only a few centers worldwide. Similar to laparoscopic living donor nephrectomy it offers the donor rapid convalescence and excellent cosmetic results. However, concerns have been expressed over the safety of endoscopic living donor nephrectomy. Methods: We review the results of 164 consecutive RLDN from November 2001 to November 2007. Complications were classified into intra- and early postoperative. Results: Mean donor age was 53.4±10.7years (27-79). Left kidneys were harvested in 76% of cases. Mean operation time was 146±44min (55-270), and warm ischemia time 131±45s (50-280). In two patients (1.2%) conversion to open nephrectomy was necessary. The intraoperative complication rate was 3.0%. In the postoperative period we observed in 17.7% minor complications with no persisting impairments for the donor. The rate of major complications in the early postoperative period was 4.3%. Three patients (1.8%) necessitated revision, due to laceration of the external iliac artery in one patient and chyloretroperitoneum in two patients. Mean donor creatinine was 113.1±26.6mg/dl (63-201) on the first postoperative day, and 102.0±22.2mg/dl (68-159) on the fifth postoperative day. Conclusion: Retroperitoneoscopic living donor nephrectomy can be performed with acceptable intraoperative and early postoperative morbidity. Operation times and warm ischemia times are comparable to the open approac

Diagnostik und Therapie der Harnleitersteinkolik

Summary: Acute ureteral colic presents with a complex of acute and characteristic flank pain that usually indicates the presence of a stone in the urinary tract. Diagnosis and management of renal colic have undergone considerable evolution and advancement in recent years. The application of noncontrast helical computed tomography (CT) in patients with suspected ureteral colic is one major advance in the primary diagnostic process. The superior sensitivity and specificity of helical CT allow ureterolithiasis to be diagnosed without the potential side effects of contrast media. Initial management is based on three key concepts: (A) rational and fast diagnostic process (B) effective pain control (C) and understanding of the impact of stone location and size on the natural course of the disease and definitive urologic management. These concepts are discussed in this review with reference to contemporary literatur