Retroperitoneoskopische Nierenchirurgie: Indikationen, Technik und eigene Erfahrungen nach 360 Eingriffen

Zusammenfassung: Die retroperitoneoskopische Operationstechnik überzeugt durch den schnellen, direkten und einfachen Zugang ins Retroperitoneum und zu den Nierengefäßen unter Umgehung des Peritonealraums. Wir beschreiben unsere Operationstechnik und diskutieren Vor- und Nachteile der Retroperitoneoskopie. Unsere Erfahrungen mit dieser Operationstechnik bei insgesamt 360 retroperitoneoskopischen Eingriffen werden vorgestellt: Nephrektomie, Nierenteilresektion, Lebendnierenspende, Kryotherapie von Nierentumoren, Pyelonplastik sowie Adrenalektomie und weitere Indikationen werden dargestellt. Wir zeigen, welche Eingriffe sich zum Einstieg in die Technik eignen und auf was geachtet werden mus

Benigne zystische Raumforderungen des Hodens: Eine Übersicht

Zusammenfassung: Hodenzysten werden im Rahmen der skrotalen Sonographie zunehmend diagnostiziert. Grund hierfür ist u.a. die flächendeckende Verfügbarkeit moderner, hochauflösender Ultraschallgeräte. Differentialdiagnostisch und ätiologisch sind benigne und maligne Erkrankungen mit testikulärer Zystenbildung voneinander zu unterscheiden. Benigne Krankheitsbilder mit zystischen Raumforderungen des Hodens sind die tubuläre Ektasie des Rete testis, die zystische Dysplasie, Epidermoidzysten, einfache intraparenchymatöse Hodenzysten und Zysten der Tunica albuginea. Die testikuläre Dermoidzyste, die lange Zeit zu Unrecht als potentiell maligne angesehen wurde, ist ebenfalls als benigne zu klassifizieren. Bei Diagnose einer benignen zystischen Raumforderung des Hodens kann in den meisten Fällen eine organerhaltende operative Therapie oder ein abwartendes, überwachendes Procedere empfohlen werde

Photoselektive Vaporisation der Prostata: Erfahrungen mit Prostataadenomen >80cm3

Zusammenfassung: Hintergrund: Wir berichten über unsere Erfahrungen mit der photoselektiven Vaporisation der Prostata (PVP) bei Patienten mit symptomatischer benigner Prostatahyperplasie (BPH) und Prostataadenomen >80cm3. Patienten und Methode: 201Patienten mit BPH wurden in die Studie eingeschlossen; 51 (25,4%) Patienten hatten ein Prostatavolumen >80cm3 und 150 (74,6%) Patienten ein Volumen 80cm3 stellt die PVP eine durchführbare Therapieoption da

An immediate-late gene expression module decodes ERK signal duration

The RAF-MEK-ERK signalling pathway controls fundamental, often opposing cellular processes such as proliferation and apoptosis. Signal duration has been identified to play a decisive role in these cell fate decisions. However, it remains unclear how the different early and late responding gene expression modules can discriminate short and long signals. We obtained both protein phosphorylation and gene expression time course data from HEK293 cells carrying an inducible construct of the proto-oncogene RAF By mathematical modelling, we identified a new gene expression module of immediate-late genes (ILGs) distinct in gene expression dynamics and function. We find that mRNA longevity enables these ILGs to respond late and thus translate ERK signal duration into response amplitude. Despite their late response, their GC-rich promoter structure suggested and metabolic labelling with 4SU confirmed that transcription of ILGs is induced immediately. A comparative analysis shows that the principle of duration decoding is conserved in PC12 cells and MCF7 cells, two paradigm cell systems for ERK signal duration. Altogether, our findings suggest that ILGs function as a gene expression module to decode ERK signal duration

Exploring CP Violation with BcB_c Decays

We point out that the pure ``tree'' decays $B_c^\pm\to D^\pm_s D$ are particularly well suited to extract the CKM angle $\gamma$ through amplitude relations. In contrast to conceptually similar strategies using $B^\pm\to K^\pm D$ or $B_d\to K^{\ast0} D$ decays, the advantage of the $B_c$ approach is that the corresponding triangles have three sides of comparable length and do not involve small amplitudes. Decays of the type $B_c^\pm\to D^\pm D$ -- the $U$-spin counterparts of $B_c^\pm\to D^\pm_s D$ -- can be added to the analysis, as well as channels, where the $D^\pm_s$- and $D^\pm$-mesons are replaced by higher resonances.Comment: 9 pages, LaTeX, 3 figures, reference adde

Comparison of the roll-plate and sonication techniques in the diagnosis of microbial ureteral stent colonisation: results of the first prospective randomised study

Background: Microbial ureteral stent colonisation (MUSC) is one leading risk factor for complications associated with ureteral stent placement. As MUSC remains frequently undetected by standard urine cultures, its definitive diagnosis depends on microbiological investigation of the stent. However, a standard reference laboratory technique for studying MUSC is still lacking. Materials and methods: A total of 271 ureteral stents removed from 199 consecutive patients were investigated. Urine samples were obtained prior to device removal. Stents were divided into four parts. Each part was separately processed by the microbiology laboratory within 6h. Ureteral stents were randomly allocated to roll-plate or sonication, respectively, and analysed using standard microbiological techniques. Demographic and clinical data were prospectively collected using a standard case-report form. Results: Overall, roll-plate showed a higher detection rate of MUSC compared with sonication (35 vs. 28%, p<0.05) and urine culture (35 vs. 8%, p<0.05). No inferiority of Maki's technique was observed even when stents were stratified according to indwelling time below or above 30days. Compared with roll-plate, sonication commonly failed to detect Enterococcus spp., coagulase-negative staphylococci (CoNS) and Enterobacteriaceae. In addition, sonication required more hands-on time, more equipment and higher training than roll-plate in the laboratory. Conclusions: This prospective randomised study demonstrates the superiority of Maki's roll-plate technique over sonication in the diagnosis of MUSC and that urine culture is less sensitive than both methods. The higher detection rate, simplicity and cost-effectiveness render roll-plate the methodology of choice for routine clinical investigation as well as basic laboratory researc

Phenomenology of neutral heavy leptons

We continue our previous work on the flavour-conserving leptonic decays of the Z boson with neutral heavy leptons (NHL's) in the loops by considering box, vertex, and self-energy diagrams for the muon decay. By inclusion of these loops (they contribute to the input parameter M_W) we can probe the full parameter space spanned by the so-called flavour-conserving mixing parameters ee_(mix), \mu\mu_(mix), \tau\tau_(mix) in a superstring-inspired model of neutrino mass. We compare the results of our analysis with the existing work in this field and conclude that flavour-conserving decays have certain advantages over traditionally considered flavour-violating ones.Comment: submitted to Phys. Rev. D, 30 pages, 9 figures (ps), REVTE

Relations among neutrino observables in the light of a large theta_13 angle

The recent T2K and MINOS indications for a "large" theta_13 neutrino mixing angle can be accommodated in principle by an infinite number of Yukawa flavour structures in the seesaw model. Without considering any explicit flavour symmetry, there is an instructive exercise one can do: to determine the simplest flavour structures which can account for the data with a minimum number of parameters, simply assuming these parameters to be uncorrelated. This approach points towards a limited number of simple structures which show the minimum complexity a neutrino mass model must generally involve to account for the data. These basic structures essentially lead to only 4 relations between the neutrino observables. We emphasize that 2 of these relations, |sin theta_13|=(tan theta_23/cos delta)*(1-tan theta_12)/(1+tan theta_12) and |sin theta_13| = sin theta_12 R^1/4, with R= Delta m^2_21/Delta m^2_32, have several distinctive properties. First, they hold not only with a minimum number of parameters, but also for complete classes of more general models. Second, any value of theta_13 within the T2K and MINOS ranges can be obtained from these relations by taking into account small perturbations. Third, they turn out to be the pivot relations of models with approximate conservation of lepton number, which allow the seesaw interactions to induce observable flavour violating processes, such as mu -> e gamma and tau -> mu gamma. Finally, in specific cases of this kind, these structures have the rather unique property to allow a full reconstruction of the seesaw Lagrangian from low energy data.Comment: 13 pages, 3 figure

Isospin Violation in Chiral Perturbation Theory and the Decays \eta \ra \pi \ell \nu and \tau \ra \eta \pi \nu

I discuss isospin breaking effects within the standard model. Chiral perturbation theory presents the appropriate theoretical framework for such an investigation in the low--energy range. Recent results on the electromagnetic contributions to the masses of the pseudoscalar mesons and the $K_{\ell 3}$ amplitudes are reported. Using the one--loop formulae for the $\eta_{\ell 3}$ form factors, rather precise predictions for the decay rates of $\eta \rightarrow \pi \ell \nu$ can be obtained. Finally, I present an estimate of the \tau \ra \eta \pi \nu branching ratio derived from the dominant meson resonance contributions to this decay.Comment: 10 pages, latex, one figure available upon reques