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  • 1
    Language: English
    In: Lasers in Surgery and Medicine, 2014, Vol.46(7), p.558(5)
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1002/lsm.22262/abstract Byline: Stefan Vallo, Katrin Eichler, Kathrin Kelly, Boris Schulz, Georg Bartsch, Axel Haferkamp, Thomas J Vogl, Stephan Zangos Purpose To evaluate the clinical value of different magnetic resonance imaging (MRI) sequences for a real-time thermo-monitoring during laser-induced thermotherapy (LITT) in kidneys. Methods Twenty-eight ex vivo pig kidneys were treated with laser ablation under MR guidance in a high-field MR scanner (Magnetom Espree or Avanto Fit, Siemens, Germany). For the thermal ablation of the kidney, a neodymium yttrium-aluminum-garnet (Nd:YAG) laser was used in combination with a special protective catheter (length 43cm, 4 French) which is sealed at the distal end. First, ablation was performed for 7, 10, and 13minutes using FLASH sequences for investigation of time-dependent growth of lesion size. In the second step, we evaluated the optimal imaging sequence during a 7minutes ablation of the kidney and after cooling using four different MR sequences (Haste, FLASH, radial VIBE, and Caipirinha DIXON). Results Macroscopic lesion volume increased from 3,784[+ or -]1,525mm.sub.3 to 7,683[+ or -]5,756mm.sub.3 after the ablation from 7 to 13minutes and MR volume ranged from 2,107[+ or -]1,674mm.sub.3 to 2,934[+ or -]1,549mm.sub.3 after the ablation from 7 to 13minutes. During ablation, FLASH (132[+ or -]34%) and radial VIBE (120[+ or -]43%) sequences displayed lesion volumes most efficiently with a trend to overestimation. The Caipirinha DIXON (323[+ or -]24%) sequence overestimated the volumes significantly during real-time monitoring. The volumes measured by MRI with FLASH (61[+ or -]30%), Haste (67[+ or -]28%), or radial VIBE (48[+ or -]14%) sequences after cooling of the kidney after ablation were always underestimated. The Caipirinha DIXON (142[+ or -]2%) sequence still overestimated the lesion volume after cooling of the kidney. Conclusion LITT is a feasible ablation modality in kidney tissue. Moreover, macroscopic and MR lesion volume increases time-dependently. For online monitoring, radial VIBE and FLASH sequences seem to be most efficient. Lasers Surg. Med. 46:558-562, 2014. [c] 2014 Wiley Periodicals, Inc. Article Note: Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
    Keywords: Magnetic Alloys – Evaluation ; Magnetic Alloys – Comparative Analysis ; Rare Earth Metals – Evaluation ; Rare Earth Metals – Comparative Analysis ; Ablation (Surgery) – Comparative Analysis ; Rare Earth Metal Compounds – Evaluation ; Rare Earth Metal Compounds – Comparative Analysis ; Diagnostic Imaging – Comparative Analysis ; Lasers – Evaluation ; Lasers – Comparative Analysis
    ISSN: 0196-8092
    E-ISSN: 10969101
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  • 2
    Language: English
    In: The Journal of Urology, April 2012, Vol.187(4), pp.e432-e432
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
    Source: ScienceDirect Journals (Elsevier)
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  • 3
    Language: English
    In: The Journal of Urology, April 2015, Vol.193(4), pp.e77-e77
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2015.02.278 Byline: Hendrik Borgmann, Jan-Henning Wolm, Michael Reiter, Kilian Gust, Stefan Vallo, Georg Bartsch, Roman Blaheta, Igor Tsaur, Axel Haferkamp Author Affiliation: Frankfurt, Germany Article Note: (footnote) Source of Funding: none
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 4
    Language: English
    In: Translational andrology and urology, December 2017, Vol.6(6), pp.1067-1080
    Description: Radical cystectomy (RC) is the standard of care treatment of localized muscle-invasive bladder cancer (BC). However, about 50% of patients develop metastases within 2 years after cystectomy. Neoadjuvant cisplatin-based chemotherapy before cystectomy improves the overall survival (OS) in patients with muscle-invasive BC. Pathological response to neoadjuvant treatment is a strong predictor of better disease-specific survival. Nevertheless, some patients do not benefit from chemotherapy. The identification of reliable biomarkers enabling clinicians to identify patients who might benefit from chemotherapy is a very important clinical task. An identification tool could lead to individualized therapy, optimizing response rates. In addition, unnecessary treatment with chemotherapy which potentially leads to a loss of quality of life and which might also might cause a delay of cystectomy in a neoadjuvant setting could be avoided. The present review aims to summarize and discuss the current literature on biomarkers for the prediction of response to systemic therapy in muscle-invasive BC. Tremendous efforts in genetic and molecular characterization have led to the identification of predictive candidate biomarkers in urothelial carcinoma (UC), although prospective validation is pending. Ongoing clinical trials examining the benefit of individual therapies in UC of the bladder (UCB) by molecular patient selection hold promise to shed light on this question.
    Keywords: Bladder Cancer (Bc) ; Biomarker ; Chemotherapy ; Immunotherapy ; Urothelial Carcinoma (Uc)
    ISSN: 2223-4691
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  • 5
    Language: English
    In: Rare Tumors, 01 February 2014, Vol.6(1)
    Description: Testicular neoplasms occur in more than 90% of cases, due to primary testicular germ cell tumors. Other entities are non germ cell tumors of the testis, testicular manifestation of lymphomas or metastases. International and interdisciplinary co-operation has led to the development of urological guidelines and to good therapeutic success for testicular neoplasms. The gold standard for treatment of a testicular neoplasm is the radical orchiectomy. However, for individual cases with suspected lymphoma, a treatment decision differing from the guidelines may be reasonable. We present the case of a 38-year-old man with testicular manifestation of a transformed mycosis fungoides, which is the most common form of cutaneous T-cell lymphoma.
    Keywords: Mycosis Fungoides, Transformation, Cd30+, Scrotal Mass, Testicular Cancer ; Medicine
    ISSN: 2036-3605
    E-ISSN: 2036-3613
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  • 6
    Language: English
    In: The Journal of Urology, 2006, Vol.175(3), pp.1122-1126
    Description: We investigated a newly developed bipolar and multipolar RF ablation system with an internally cooled electrode and resistance controlled power output in a standardized model of perfused ex vivo kidney tissue. RF energy was applied at different power levels (20, 30 and 60 W) for 1, 3, 5 and 9 minutes. Each treatment parameter was repeated 5 times. For the 20/30 W levels a bipolar electrode with an active conducting part of 20/30 mm was selected. At 60 W 2 bipolar electrodes with an active conducting part (30 mm each) were connected. Lesion volumes and shapes were calculated by measuring the maximum vertical, long axis and short axis diameters of the macroscopic lesion. Lesion volume increased significantly with the treatment time and generator power applied (p 〈0.0001). Lesion size in multipolar ablated zones was larger than that in bipolar ablated zones. A reliable dose-effect relationship existed between the generator power/applied treatment time and ablated tissue lesion size. All lesions were elliptical. Bipolar and multipolar RF ablation with an internally cooled electrode and tissue resistance control represent an interesting advance in RF technology. The development of lesion size and volume is predictable, while a uniform lesion shape can be achieved in perfused ex vivo kidney tissue. Further in vivo trials are required to test whether complete and reliable tumor tissue ablation is possible with this system.
    Keywords: Kidney ; Surgical Procedures ; Minimally Invasive ; Carcinoma ; Renal Cell ; Catheter Ablation ; Swine ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 7
    Language: English
    In: BMC cancer, 07 April 2015, Vol.15, pp.224
    Description: Acquired resistance to standard chemotherapy causes treatment failure in patients with metastatic bladder cancer. Overexpression of pro-survival Bcl-2 family proteins has been associated with a poor chemotherapeutic response, suggesting that Bcl-2-targeted therapy may be a feasible strategy in patients with these tumors. The small-molecule pan-Bcl-2 inhibitor (-)-gossypol (AT-101) is known to induce apoptotic cell death, but can also induce autophagy through release of the pro-autophagic BH3 only protein Beclin-1 from Bcl-2. The potential therapeutic effects of (-)-gossypol in chemoresistant bladder cancer and the role of autophagy in this context are hitherto unknown. Cisplatin (5637(r)CDDP(1000), RT4(r)CDDP(1000)) and gemcitabine (5637(r)GEMCI(20), RT4(r)GEMCI(20)) chemoresistant sub-lines of the chemo-sensitive bladder cancer cell lines 5637 and RT4 were established for the investigation of acquired resistance mechanisms. Cell lines carrying a stable lentiviral knockdown of the core autophagy regulator ATG5 were created from chemosensitive 5637 and chemoresistant 5637(r)GEMCI(20) and 5637(r)CDDP(1000) cell lines. Cell death and autophagy were quantified by FACS analysis of propidium iodide, Annexin and Lysotracker staining, as well as LC3 translocation. Here we demonstrate that (-)-gossypol induces an apoptotic type of cell death in 5637 and RT4 cells which is partially inhibited by the pan-caspase inhibitor z-VAD. Cisplatin- and gemcitabine-resistant bladder cancer cells exhibit enhanced basal and drug-induced autophagosome formation and lysosomal activity which is accompanied by an attenuated apoptotic cell death after treatment with both (-)-gossypol and ABT-737, a Bcl-2 inhibitor which spares Mcl-1, in comparison to parental cells. Knockdown of ATG5 and inhibition of autophagy by 3-MA had no discernible effect on apoptotic cell death induced by (-)-gossypol and ABT-737 in parental 5637 cells, but evoked a significant increase in early apoptosis and overall cell death in BH3 mimetic-treated 5637(r)GEMCI(20) and 5637(r)CDDP(1000) cells. Our findings show for the first time that (-)-gossypol concomitantly triggers apoptosis and a cytoprotective type of autophagy in bladder cancer and support the notion that enhanced autophagy may underlie the chemoresistant phenotype of these tumors. Simultaneous targeting of Bcl-2 proteins and the autophagy pathway may be an efficient new strategy to overcome their "autophagy addiction" and acquired resistance to current therapy.
    Keywords: Gossypol -- Analogs & Derivatives ; Proto-Oncogene Proteins C-Bcl-2 -- Genetics ; Urinary Bladder Neoplasms -- Drug Therapy
    E-ISSN: 1471-2407
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  • 8
    Language: English
    In: The Journal of Urology, April 2016, Vol.195(4), pp.e538-e539
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.juro.2016.02.119 Byline: Atiqullah Aziz Author Affiliation: Hamburg, Germany Article Note: (footnote) Source of Funding: None
    Keywords: Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 9
    Language: English
    In: Central European journal of urology, 2017, Vol.70(3), pp.275-279
    Description: Vasectomy is the simplest, safest, and most effective form of definitive fertility control in men [1]. Vasectomy is used for 10% of contraception worldwide but only for 2% in Germany [2]. The aim of this study was to investigate the impact of vasectomy on the sexual satisfaction of sterilized men and their partners. Vasectomized men and their partners were surveyed by means of the IIEF (International Index for Erectile Function) and the FSFI (Female Sexual Function Index) questionnaires. A total of 294 couples were surveyed; 90 men answered the IIEF, and 74 women answered the FSFI. The results of the questionnaires were compared to a historical comparison group. The men were also surveyed with a not validated questionnaire, which was returned by 95 men. The two-sample t-test for independent samples, the chi-squared test, and the Wilcoxon-Mann-Whitney test were carried out. The vasectomized men had significantly better results than the healthy historical comparison group in the IIEF domains of erectile function, orgasm, sexual desire, and intercourse satisfaction. For the female partners of the sterilized men, there were almost no significant differences in any questions of the FSFI in comparison to the control group. A significant difference was observed only in the domain 'arousal'. Vasectomy does not have a negative impact on the sexual satisfaction of the affected couples. In fact, sexual satisfaction improved for the sterilized men, while the satisfaction of the women was not reduced by the vasectomy.
    Keywords: Fsf ; Iief ; Sexual Satisfaction ; Vasectomy
    ISSN: 2080-4806
    E-ISSN: 20804873
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  • 10
    In: BJU International, February 2016, Vol.117(2), pp.272-279
    Description: Byline: Atiqullah Aziz, Shahrokh F. Shariat, Florian Roghmann, Sabine Brookman-May, Christian G. Stief, Michael Rink, Felix K. Chun, Margit Fisch, Vladimir Novotny, Michael Froehner, Manfred P. Wirth, Marco J. Schnabel, Hans-Martin Fritsche, Maximilian Burger, Armin Pycha, Antonin Brisuda, Marko Babjuk, Stefan Vallo, Axel Haferkamp, Jan Roigas, Joachim Noldus, Regina Stredele, Bjorn Volkmer, Patrick J. Bastian, Evanguelos Xylinas, Matthias May Keywords: bladder cancer; radical cystectomy; mortality; nomograms; outcome Objective To externally validate the pT4a-specific risk model for cancer-specific survival (CSS) proposed by May etal. (Urol Oncol 2013; 31: 1141-1147) and to develop a new pT4a-specific nomogram predicting CSS in an international multicentre cohort of patients undergoing radical cystectomy (RC) for urothelial carcinoma of the bladder (UCB) Patients and Methods Data from 856 patients with pT4a UCB treated with RC at 21 centres in Europe and North-America were assessed. The risk model proposed by May etal., which includes female gender, presence of positive lymphovascular invasion (LVI) and lack of adjuvant chemotherapy administration as adverse predictors for CSS, was applied to our cohort. For the purpose of external validation, model discrimination was measured using the receiver-operating characteristic-derived area under the curve. A nomogram for predicting CSS in pT4a UCB after RC was developed after internal validation based on multivariable Cox proportional hazards regression analysis evaluating the impact of clinicopathological variables on CSS. Decision-curve analyses were applied to determine the net benefit derived from the two models. Results The estimated 5-year-CSS after RC was 34% in our cohort. The risk model devised by May etal. predicted individual 5-year-CSS with an accuracy of 60.1%. In multivariable Cox proportional hazards regression analysis, female gender (hazard ratio [HR] 1.45), LVI (HR 1.37), lymph node metastases (HR 2.54), positive soft tissue surgical margins (HR 1.39), neoadjuvant (HR 2.24) and lack of adjuvant chemotherapy (HR 1.67, all P 〈 0.05) were independent predictors of an adverse CSS rate and formed the features of our nomogram with a predictive accuracy of 67.1%. Decision-curve analyses showed higher net benefits for the use of the newly developed nomogram in our cohort over all thresholds. Conclusions The risk model devised by May etal. was validated with moderate discrimination and was outperformed by our newly developed pT4a-specific nomogram in the present study population. Our nomogram might be particularly suitable for postoperative patient counselling in the heterogeneous cohort of patients with pT4a UCB. Article Note: A.A. and S.F.S. contributed equally to the study.
    Keywords: Bladder Cancer ; Radical Cystectomy ; Mortality ; Nomograms ; Outcome
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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