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  • 1
    Language: English
    In: The Journal of Urology, 2001, Vol.166(4), pp.1399-1400
    Description: Byline: CHRIS PROTZEL, JOHANNES B. DAHM, KLAUS J. KLEBINGAT Keywords: ureter; stents; abnormalities Author Affiliation: From the Departments of Urology and Cardiology, Ernst Moritz Arndt University, Greifswald, Germany Article Note: (footnote) Accepted for publication May 18, 2001.
    Keywords: Ureter ; Stents ; Abnormalities ; Medicine
    ISSN: 0022-5347
    E-ISSN: 1527-3792
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  • 2
    Language: English
    In: Journal of Geriatric Oncology, May 2017, Vol.8(3), pp.216-219
    Description: Two-thirds of all cancer cases affect patients who are older than 65 years, yet the specific conditions of the treatment and supportive care in this age group are poorly studied. There are limited data on the specific psycho-oncological problems in elderly patients with genito-urinary cancers. The aim of this study was to investigate the psychosocial needs of elderly patients with genito-urinary tumors using screening questionnaires and to use such screening questionnaires for an in-patient psychosocial treatment program. Patients (≥ 65 years, n = 319) who underwent surgical (n = 295) or medical treatment (n = 24) for genito-urinary malignancies between 06/2014 and 11/2015 in our institution were included for prospective stress assessment. This was done with standardized questionnaires for stress screening and for the identification of need for care (NCCN Distress Thermometer and Hornheider Screening Instrument, HSI). The patients scored an average of 4.4 on the Distress Thermometer. According to the survey evaluation, 28% of patients had need for psychosocial care. However, only a minority of patients (4%) did actually communicate any need for psychosocial care. We also assessed the actual utilization of inpatient psychosocial support which is offered to all patients. There is a significant number of elderly patients with genito-urinary cancer with increased psychological stress and a consecutive need of psychosocial care. This is underreported and underused by the patients. Therefore, an easy low-threshold access system with an interdisciplinary and inter-professional collaborative support system would be desirable. Measuring psychological distress systematically can be helpful in treating older patients with malignant diseases.
    Keywords: Geriatrics ; Urology ; Psychooncology ; Distress ; Psychological Stress ; Genito-Urinary Tumors ; Acute Treatment ; Medicine
    ISSN: 1879-4068
    E-ISSN: 1879-4076
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  • 3
    Language: English
    In: BMC urology, 15 October 2015, Vol.15, pp.104
    Description: Rho kinase (ROCK) and myosin-light chain kinase (MLCK) are key enzymes in smooth muscle contraction. Previous data have suggested that ROCK contribution to human detrusor contraction is increasing with age. Here, we have analyzed the transcriptional expression of Rho kinase isoforms (ROCK1 and ROCK2) as well as MLCK in the aging human detrusor smooth muscle obtained from resected tissue. Small pieces of macroscopically healthy human detrusor smooth muscle (urothelium-free) were prepared for quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR). Transcript expression (mRNA level) of the target genes ROCK1, ROCK2 and MLCK was normalized to three common reference genes (glyceraldehyde-3-phosphate dehydrogenase, β-actin, phosphoglycerate kinase 1). We found that across all ages the expression level of ROCK (i.e. ROCK1 and ROCK2 together) was almost equal to that of MLCK in the human bladder. Further, ROCK2 showed a significantly higher expression level than ROCK1. Among all subjects, there was no significant correlation of any single target gene to age, but expression levels of ROCK and MLCK were inversely correlated. Moreover, the within-subject analysis revealed that the ROCK-to-MLCK ratio showed a significantly negative correlation to age. Thus, within a given subject, there is a relative ROCK down-regulation and concomitant MLCK up-regulation. Together with previous data in human detrusor specimens showing increased ROCK contribution to detrusor contraction, we speculate that the drop of the ROCK-to-MLCK ratio may occur as an attempt to compensate for the increased Rho kinase activity.
    Keywords: Aging -- Metabolism ; Muscle, Smooth -- Enzymology ; Urinary Bladder -- Enzymology ; Rho-Associated Kinases -- Metabolism
    E-ISSN: 1471-2490
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  • 4
    In: BJU International, January 2018, Vol.121(1), pp.101-110
    Description: To purchase or authenticate to the full-text of this article, please visit this link: http://onlinelibrary.wiley.com/doi/10.1111/bju.14012/abstract Byline: Malte W. Vetterlein, Philipp Gild, Luis A. Kluth, Thomas Seisen, Michael Gierth, Hans-Martin Fritsche, Maximilian Burger, Chris Protzel, Oliver W. Hakenberg, Nicolas Landenberg,Florian Roghmann, Joachim Noldus, Philipp Nuhn, Armin Pycha, Michael Rink, Felix K.-H. Chun, Matthias May, Margit Fisch,Atiqullah Aziz,, G Bartsch, C Bolenz, S Brookman-May, A Buchner, M Durschnabel, J Ellinger, M Froehner, G Georgieva, C Gilfrich, M Gorduk, MO Grimm, B Hadaschik, A Haferkamp, F Hartmann, E Herrmann, L Hertle, M Hohenfellner, G Janetschek, B Keck, N Kraischits, A Krausse, L Lusuardi, T Martini, MS Michel, R Moritz, SC Muller, V Novotny, S Pahernik, RJ Palisaar, A Ponholzer, J Roigas, M Schmid, P Schramek, C Seitz, D Sikic, CG Stief, I Syring, M Traumann, S Vallo, FM Wagenlehner, W Weidner, MP Wirth, B Wullich Keywords: blood transfusion; cystectomy; propensity score; recurrence; survival Objectives To evaluate the effect of peri-operative blood transfusion (PBT) on recurrence-free survival, overall survival, cancer-specific mortality and other-cause mortality in patients undergoing radical cystectomy (RC), using a contemporary European multicentre cohort. Patients and Methods The Prospective Multicentre Radical Cystectomy Series (PROMETRICS) includes data on 679 patients who underwent RC at 18 European tertiary care centres in 2011. The association between PBT and oncological survival outcomes was assessed using Kaplan-Meier, Cox regression and competing-risks analyses. Imbalances in clinicopathological features between patients receiving PBT vs those not receiving PBT were mitigated using conventional multivariable adjusting as well as inverse probability of treatment weighting (IPTW). Results Overall, 611 patients had complete information on PBT, and 315 (51.6%) received PBT. The two groups (PBT vs no PBT) differed significantly with respect to most clinicopathological features, including peri-operative blood loss: median (interquartile range [IQR]) 1000 (600-1500) mL vs 500 (400-800) mL (P 〈 0.001). Independent predictors of receipt of PBT in multivariable logistic regression analysis were female gender (odds ratio [OR] 5.05, 95% confidence interval [CI] 2.62-9.71; P 〈 0.001), body mass index (OR 0.91, 95% CI 0.87-0.95; P 〈 0.001), type of urinary diversion (OR 0.38, 95% CI 0.18-0.82; P = 0.013), blood loss (OR 1.32, 95% CI 1.23-1.40; P 〈 0.001), neoadjuvant chemotherapy (OR 2.62, 95% CI 1.37-5.00; P = 0.004), and a[yen]pT3 tumours (OR 1.59, 95% CI 1.02-2.48; P = 0.041). In 531 patients with complete data on survival outcomes, unweighted and unadjusted survival analyses showed worse overall survival, cancer-specific mortality and other-cause mortality rates for patients receiving PBT(P 〈 0.001, P = 0.017 and P = 0.001, respectively). After IPTW adjustment, those differences no longer held true. PBT was not associated with recurrence-free survival (hazard ratio [HR] 0.92, 95% CI 0.53-1.58; P = 0.8), overall survival (HR 1.06, 95% CI 0.55-2.05; P = 0.9), cancer-specific mortality (sub-HR 1.09, 95% CI 0.62-1.92; P = 0.8) and other-cause mortality (sub-HR 1.00, 95% CI 0.26-3.85; P 〉 0.9) in IPTW-adjusted Cox regression and competing-risks analyses. The same held true in conventional multivariable Cox and competing-risks analyses, where PBT could not be confirmed as a predictor of any given endpoint (all P values 〉0.05). Conclusion The present results did not show an adverse effect of PBT on oncological outcomes after adjusting for baseline differences in patient characteristics. Article Note: M.W.V. and P.G. contributed equally to the work. PROMETRICS 2011 Study Group members are present in Appendix 1.
    Keywords: Blood Transfusion ; Cystectomy ; Propensity Score ; Recurrence ; Survival
    ISSN: 1464-4096
    E-ISSN: 1464-410X
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  • 5
    In: Acta Pharmacologica Sinica, 2013, Vol.35(1), p.74
    Description: AIM: Activation of muscarinic receptors on the detrusor smooth muscle is followed by contraction, which involves both myosin light chain kinase (MLCK) and Rho kinase (ROCK). The aim of this study was to determine the relative contributions of MLCK and ROCK to carbachol-induced contraction of human detrusor smooth muscle in vitro.METHODS: Detrusor smooth muscle strips were prepared from the macroscopically unaffected bladder wall of patients underwent cystectomy. The strips were fixed in an organ bath, and carbachol or KCl-induced isometric contractions were measured by force transducers.RESULTS: Addition of carbachol (0.4-4 μmol/L) into the bath induced concentration-dependent contractions of detrusor specimens, which was completely abolished by atropine (1 μmol/L). Pre-incubation of detrusor specimens with either the MLCK inhibitor ML-9 or the ROCK inhibitors HA1100 and Y-27632 (each at 10 μmol/L) significantly blocked carbachol-induced contractions as compared to the time-control experiments. Moreover, MLCK and ROCK inhibition were equally effective in reducing carbachol-induced contractions. The residual carbachol-induced contractions in the presence of both MLCK and ROCK inhibitors were significantly smaller than the contractions obtained when only one enzyme (either MLCK or ROCK) was inhibited, suggesting an additive effect of the two kinases. Interestingly, ROCK-mediated carbachol-induced contractions were positively correlated to the age of patients (r=o.52, P〈0.05).CONCLUSION: Both MLCK and ROCK contribute to carbachol-induced contractions of human detrusor smooth muscle. ROCK inhibitors may be a new pharmacological approach to modulate human bladder hyperactivity.
    Keywords: Pharmacy, Therapeutics, & Pharmacology;
    ISSN: 1671-4083
    E-ISSN: 17457254
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  • 6
    In: Circulation: Journal of the American Heart Association, 2001, Vol.104(21), pp.2627-2627
    Keywords: Atherectomy–Methods ; Constriction, Pathologic–Diagnostic Imaging ; Female–Surgery ; Humans–Diagnostic Imaging ; Middle Aged–Surgery ; Radiography–Methods ; Ureter–Diagnostic Imaging ; Urinary Catheterization–Surgery ; Urologic Diseases–Surgery ; Abridged;
    ISSN: 0009-7322
    E-ISSN: 15244539
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  • 7
    Language: English
    In: International journal of urology : official journal of the Japanese Urological Association, March 2015, Vol.22(3), pp.322-9
    Description: To analyze the effect of adenosine on detrusor smooth muscle contraction and to assess age-related changes of adenosine function. Sustained contractions were induced in young (10-30 days) and old (〉60 days) rat detrusor muscle strips by application of 30 mmol/L K(+) and adenosine (0.1-400 µmol/L), which was either applied before raising the K(+) concentration or added to the precontracted muscle strip. Quantitative polymerase chain reaction analyses were used to study adenosine receptor expression in rat and human detrusor specimens. Pretreatment with adenosine dose-dependently reduced subsequent K(+) -induced contraction in detrusor muscle strips from young rats (half-maximal effect = 40 µmol/L). The residual depolarization-induced contraction strength in young tissue was significantly smaller than in tissue from old animals, showing a greater potency of adenosine in young detrusor samples. Likewise, the relaxing effect of adenosine on precontracted detrusor muscle was also significantly more pronounced in young compared with older detrusor. Quantitative polymerase chain reaction showed an age-related downregulation of the adenosine A2B receptor in rat detrusor tissues, which could be confirmed in human detrusor samples. Furthermore, relaxation of both K(+) -induced as well as carbachol-induced contraction by the specific A2B receptor agonist BAY 60-6583 was significantly more pronounced in young than in old rats. Adenosine powerfully counteracts contraction of detrusor smooth muscle, which is lost in the aging bladder. This is paralleled by an age-dependent transcriptional downregulation of the low-affinity A2B receptor. Hence, this might be pathophysiologically relevant in conditions of raised adenosine concentrations, such as hyperactive bladder contractility.
    Keywords: Detrusor ; Isometric Contraction ; Organ Bath ; Real-Time Polymerase Chain Reaction ; Adenosine -- Therapeutic Use ; Adenosine A2 Receptor Agonists -- Therapeutic Use ; Aminopyridines -- Therapeutic Use ; Muscle Contraction -- Drug Effects ; Muscle, Smooth -- Drug Effects ; Receptor, Adenosine A2b -- Metabolism ; Urinary Bladder, Overactive -- Drug Therapy
    ISSN: 09198172
    E-ISSN: 1442-2042
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  • 8
    In: Cardiovascular Research, 2010, Vol. 85(4), pp.814-824
    Description: AIMS: The present study was performed to investigate the contribution of NADPH oxidases (Nox) to superoxide formation in human renal proximal resistance arteries and to test whether superoxide formation contributes to acute vasoconstrictor responses and endothelium-dependent vasodilation in these vessels.METHODS AND RESULTS: Arcuate and proximal interlobular artery segments were from patients who underwent nephrectomy because of a renal tumour. Vessels were dissected from tumour-free parts of the kidneys. Additional intrarenal arteries were obtained from rats. Superoxide formation was measured by lucigenin-enhanced chemiluminescence, expression of Nox isoforms was analysed by RT-PCR, and functional studies were performed by small vessel wire myography. Sixty per cent of superoxide formation in human arcuate and proximal interlobular arteries was due to Nox activity. mRNA expression analyses revealed the presence of Nox2 and Nox4 but not Nox1. Phenylephrine and endothelin-1 induced powerful concentration-dependent vasoconstrictions that were unaffected by superoxide scavengers. Vasopressin elicited small and variable vasoconstrictions with signs of tachyphylaxis. Endothelium-dependent vasodilation was blunted by tiron and Nomega-nitro-L-arginine methyl ester but not by superoxide dismutase or catalase. Exogenous hydrogen peroxide elicited vasoconstriction.CONCLUSION: Nox activity is the major source of superoxide formation in renal proximal resistance arteries from elderly patients. Acute vasoconstrictor responses to alpha1-adrenoreceptor activation and to endothelin-1 do not depend on superoxide formation, while endothelium-dependent vasodilation in intrarenal arteries is reactive oxygen species-dependent.
    Keywords: Arterial Function ; Nadph Oxidase ; Oxygen Radicals ; Endothelium ; Renal Function
    ISSN: 0008-6363
    E-ISSN: 1755-3245
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  • 9
    Language: English
    In: Urologic Oncology: Seminars and Original Investigations, January 2018, Vol.36(1), pp.11.e1-11.e6
    Description: To describe the course of disease of patients surgically treated for locally recurrent renal cell carcinoma (LRRCC) after nephrectomy and to identify potential predictive factors for long-term survival. We, retrospectively, identified 54 patients who underwent surgical resection of LRRCC after open nephrectomy for localized kidney cancer. The median age at time of surgery for LRRCC was 65 years. Survival rates were determined with the Kaplan-Meier method. Mantel-Haenszel hazard ratios were calculated. Comparisons were made with the log-rank test. Cox proportional hazard models were used to analyze combined effects of variables. Median time to local recurrence after nephrectomy was 36 months (5–242 months). Median follow-up after surgery for LRRCC was 39 months. At time of analysis 18 patients (33%) were alive without any evidence of disease, 8 patients (15%) were alive with disease, 20 patients (37%) died of renal cell carcinoma, and 8 patients (15%) died of other causes. A 5-year overall survival (OS) was 60% (95% CI: 0.44–0.73) and 10-year OS was 32% (95% CI: 0.15–0.51). The median survival after surgery for LRRCC was 79 months. In univariate analysis OS differed significantly by the time period between primary surgery and occurrence of LRRCC (〈2 years vs. ≥2 years: 10-year OS rate 31% (95% CI: 10.2–55.0) vs. 45% (95% CI: 21.5–65.8; hazard ratio = 0.26; = 0.0034). In multivariate analysis sarcomatoid features in the primary nephrectomy specimen, positive surgical margins of the LRRCC specimen and a Charlson score of ≥2 were associated with a significantly worse prognosis in this cohort. In patients with a disease-free interval of more than 2 years after surgery for the primary tumor, surgical removal of LRRCC may achieve long-term survival in most patients. In those with a shorter disease-free interval, long-term survival is unlikely.
    Keywords: Kidney Neoplasms ; Renal Cell Carcinoma ; Local Recurrence ; Prognosis ; Medicine
    ISSN: 1078-1439
    E-ISSN: 1873-2496
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  • 10
    Language: English
    In: Human Pathology, 2011, Vol.42(8), pp.1078-1088
    Description: Acquired chromosomal aberrations, including gene copy number alterations, are involved in the development and progression of human malignancies. , a transcription factor–coding gene located at 3q26.33, is known to be recurrently and specifically amplified in squamous cell carcinomas of the lung, the esophagus, and the oral cavity. In these organs, the SOX2 protein plays an important role in tumorigenesis and tumor survival. The aim of this study was to determine whether amplification is also found in squamous cell carcinomas in other organs commonly affected by this tumor entity. In addition, we examined a large spectrum of lung cancer entities with neuroendocrine differentiation (ie, small cell cancers, large cell cancers, typical and atypical carcinoids) for and copy number gains to reveal potential molecular ties to squamous cell carcinomas or adenocarcinomas of the lung. Applying fluorescence in situ hybridization, we assessed squamous cell carcinomas of the cervix uteri (n = 47), the skin (n = 57), and the penis (n = 53) for copy number alterations and detected amplifications in 28%, 28%, and 32% of tumors, respectively. Furthermore, we performed immunohistochemical SOX2 staining and found that amplification is significantly associated with overexpression of the corresponding protein in squamous cell carcinomas ( 〈 .001). Of the lung cancer entities with neuroendocrine differentiation, only small cell cancers and large cell cancers exhibited or amplifications at significant frequencies, indicating that at least a subset of these might be dedifferentiated forms of squamous cell carcinomas or adenocarcinomas of the lung. We conclude that amplification and consequent SOX2 protein overexpression may represent important mechanisms of tumor initiation and progression in a considerable subset of squamous cell carcinomas.
    Keywords: Sox2 ; Squamous Cell Carcinoma ; Skin ; Penis ; Uterine Cervix ; Medicine
    ISSN: 0046-8177
    E-ISSN: 1532-8392
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