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The International Collaboration on Cancer Reporting (ICCR) is a not-for-profit organisation sponsored by the Royal Colleges of Pathologists of Australasia and the United Kingdom, the College of American Pathologists, the Canadian Association of Pathologists in association with the Canadian Partnership Against Cancer, the European Society of Pathology, the American Society of Clinical Pathology and the Faculty of Pathology, Royal College of Physicians of Ireland. Its goal is to produce standardised, internationally agreed-upon, evidence-based datasets for cancer pathology reporting throughout the world. This paper describes the development of a cancer dataset by the multidisciplinary ICCR expert panel for the reporting of carcinoma of the urethra in urethrectomy specimens. The dataset is composed of 'required' (mandatory) and 'recommended' (non-mandatory) elements, which are based on a review of the most recent evidence and supported by explanatory commentary. Fourteen required elements and eight recommended elements were agreed by the international dataset authoring committee to represent the essential/required (core) and recommended (non-core) information for the reporting of carcinoma of the urethra in urethrectomy specimens. Use of an internationally agreed, structured pathology dataset for reporting carcinoma of the urethra (in urethrectomy specimens) will provide the necessary information for optimal patient management, will facilitate consistent data collection and will provide valuable data for research and international benchmarking. The dataset will be valuable for those countries and institutions that are not in a position to develop their own datasets. more...

Introduction Reliable nuclear immunohistochemical stains for sebaceous neoplasms have not been readily available. Positive nuclear staining has been reported by GATA3 and factor XIIIa (AC-1A1). We sought to determine the diagnostic utility of these nuclear stains by comparing their staining pattern to adipophilin, a consistently positive cytoplasmic stain. Methods Cases with the diagnosis of sebaceous hyperplasia, sebaceous adenoma, sebaceous epithelioma/sebaceoma, and sebaceous carcinoma, nonsebaceous neoplasms (basal cell carcinoma, and squamous cell carcinoma) were examined. Intensity and extent of staining of the basal cells and mature sebocytes were evaluated for each stain. Results Factor XIIIa (AC-1A1) was 87.3% sensitive for all sebaceous neoplasms and 95.1% specific and demonstrated high inter-observer reliability. Adipophilin was 83.2% sensitive and 87.8% specific. GATA3 was the least sensitive (80.9%) and specific (75.6%) marker. When factor XIIIa was compared against composite staining of all three markers its staining was still uniquely significant (p = 0.0210). Conclusion Factor XIIIa (AC-1A1) is a sensitive and specific nuclear marker for sebaceous differentiation. Its diagnostic utility exceeds that of adipophilin. Factor XIIIa should be included in the expanding group of immunohistochemical and special stains which can be utilized to aid in the diagnosis of sebaceous neoplasms. more...

Domestic politics and foreign policy have long been intertwined. The notion of "politics stopping at the water's edge" as Senator Arthur Vandenberg famously argued in 1947 has largely been just that, a convenient notion. Political oppositions, Congress, and others have long criticized a president's foreign policies for political advantage. In 1916, Republican presidential candidate Eliot Root rebuked both President Wilson and the administration for their handling of the nation's foreign affairs (Chicago Daily Tribune 1916a). Similarly, Republican National Committee Chairman William R. Willcox accused the Wilson administration of playing politics with foreign policy (Chicago Daily Tribune 1916b). And while some consensus appeared, both between parties and branches for the early years of the Cold War, domestic politics has always been part of presidential decisions of whether, when, and where to use force. For example, after the beginning of the Korean War in 1950 and the subsequent dismissal of MacArthur from his command, a divide emerged between parties over which would be better at prosecuting the war (Belknap and Campbell 1951). Recent events suggest politics continues to be part of foreign policy. Whether it is the "Red Line" that never was, the events of Benghazi, or the continued fighting in Iraq and Afghanistan, all of these events have spilled over into politics, highlighting how foreign policy and domestic politics are intrinsically intertwined. Much of the research examining this intersection of politics and policy examines presidential, or executive, uses of force. This research focuses on the political constraints that executives face in attempting to achieve foreign policy goals and on the political incentives that presidents may have to use foreign policy tools for domestic political purposes. Studies focusing on the incentives or disincentives to use force typically examine the state of the economy and public opinion and build from either the diversionary hypothesis framework and/or the rally 'round the flag effect. Research on constraints examines executive legislative relations and the influence of the election cycle. Is Congress united or divided? Is it of the same party of the president? Are elections drawing near when the public can directly hold a president accountable? Do term limits alter incentives and constraints? The articles in this issue examine these research areas involving presidents and the use of force abroad. As noted above, scholars trying to understand how domestic politics interacts with choices to use military violence abroad focus on four broad and related research areas. The first is executive--legislative relations. Given the nature of checks and balances in the system, one would expect Congress to be involved in the foreign policy process just as it is in the domestic political arena. On the one hand, there is some consensus that Congress is less than active in intervening in the decisions about when and where presidents use force. Hickley (1994) suggests that Congress usually defers to the presidency on these questions. Howell and Pevehouse (2005) come to similar conclusions, suggesting that executives are unfettered by congressional interference, reinforcing the notion of two presidencies, one foreign and one domestic. However, other research suggests that executive--legislative relations do influence use-of-force decisions. Congress can use institutional means such as budgetary and appropriations restrictions, reporting requirements, and oversight investigations to influence policy. Members of Congress can use their own political positions to publicly denounce foreign policy choice and maximize blame for failed foreign policies, undermining public support and presidential approval (Foster 2006; Marshall and Haney 2010). Furthermore, work suggests that the partisan composition of Congress matters. Is the government united under a single party or does the opposition control the House, Senate, or both? … more...

War heightens public interest in politics, especially when human lives are lost. We examine whether, and how, combat casualties affect the decision to vote in established democracies. Drawing from social psychology research on mortality salience, we expect increasing casualties to increase the salience of death, information that moves people to defend their worldview, especially nationalistic and ideological values. By heightening the importance of values, we propose that combat casualties increase the benefits of voting. In particular, we expect the effect of combat casualties to be pronounced among the least politically engaged. Using both cross-national data of elections in 23 democracies over a 50-year period and survey data from the United States and United Kingdom during the Iraq and Afghanistan wars, we found that mounting casualties increase turnout. Furthermore, as expected, we found the effect of casualties to be most pronounced among those least interested in politics. [ABSTRACT FROM AUTHOR] more...

Objectives To assess the effect of non-squamous differentiation (non-SQD) variant histology on survival in muscle-invasive bladder urothelial cancer (UC). Patients and Methods A cohort of 411 radical cystectomy (RC) cases performed with curative intent for muscle-invasive primary UC was identified between 2008 and June 2013. Survival analysis was evaluated using Kaplan–Meier methodology comparing non-variant (NV) + SQD histology to non-SQD variant histology (non-SQD variants). Multivariable cox proportional hazards regression assessed all-cause and disease-specific mortality. Results Of the 411 RC cases, 77 (19%) had non-SQD variant histology. The median overall survival (OS) for non-SQD variant histology was 28 months, whereas the NV+SQD group had not reached the median OS at 74 months (log-rank test P < 0.001). After adjusting for sex, age, pathological stage, and any systemic chemotherapy, patients with non-SQD variant histology at RC had a 1.57-times increased adjusted risk of all-cause mortality (P = 0.027) and 1.69-times increased risk of disease-specific mortality (P = 0.030) compared with NV+SQD patients. Conclusions While SQD behaves similarly to NV, non-SQD variant histology portends worse OS and disease-specific survival regardless of neoadjuvant or adjuvant chemotherapy and pathological stage. Non-SQD variants of UC could perhaps be considered a distinct clinical entity in UC with goals for developing new treatment algorithms through novel clinical trials. more...

Faith in and fascination with angels have been on the rise in popular culture in Germany. Rainer Maria Rilke's poetry is frequently mentioned in connection with these supposedly divine beings, which perpetuates a conflation of Rilke's works with spirituality and transcendence among the broad population. Various media outlets in Germany reinforce this connection in time for Christmas each year. Rilke's angel figure is, however, not exclusively or even primarily a foil for metaphysical or spiritual considerations. Rather, Rilke's angel often rubs prevalent and solely spiritual understandings of these divine messengers against the grain, employing the angel in connection with human language and other physiological processes. Rilke's Duineser Elegien make this connection explicit, but his earlier works also point clearly to the angel as a motif in his considerations of language and communication. At a much earlier point in his career, Rilke's Engellieder cycle of 1897 turns the conventional human-angel relationship on its head, while three angel poems he wrote in the summer of 1899 reveal an attempt to approach the issue of verbal communication via the angel in a systematic manner. Der Glaube an Engel und die geistige Beschaftigung mit ihnen nehmen in der breiten Bevolkerung in Deutschland zu. Die Gedichte von Rainer Maria Rilke werden haufig im Zusammenhang mit diesen uberirdischen Wesen erwahnt, und das fordert die verbreitete Verbindung seiner Werke mit Spiritualitat und geistiger Transzendenz. Zu Weihnachten wird diese Verbindung von mehreren Medien in Deutschland verstarkt. Dennoch ist Rilkes Engel-Figur nicht ausschlieslich – ja, nicht einmal in erster Linie – ein Gegenstand metaphysischer oder spiritueller Uberlegungen. Stattdessen geht Rilke vorherrschenden Vorstellungen von Engeln gegen den Strich und verwendet den Engel im Zusammenhang mit menschlicher Sprache und anderen physiologischen Vorgangen. Das wird deutlich in Rilkes Duineser Elegien, aber auch seine viel fruheren Werke weisen eindeutig auf den Engel als Vehikel fur Uberlegungen zu Sprache und Kommunikationen. Schon Rilkes Engellieder Zyklus (1897) dreht das herkommliche Verhaltnis zwischen Mensch und Engel auf den Kopf; und drei Engel-Gedichte aus dem Sommer 1897 deuten auf den Versuch Rilkes hin, das Thema von verbaler Mitteilung und dem Engel systematisch anzugehen. more...

• The reported incidence of prostate cancer has risen since the implementation of screening. It is felt that the introduction of widespread prostate-specific antigen testing is responsible for most patients with prostate cancer now being diagnosed with asymptomatic, clinically localised disease. • Diagnosis at this stage is associated with significantly improved treatment outcomes and longer life expectancy. Although there is evidence that screening has reduced prostate cancer mortality, there is a risk of over-diagnosis and over-treatment of early state prostate cancers, including clinically insignificant and indolent cancers. • Active surveillance and focal therapy have been advocated as potential management options for some patients. However, these approaches face several challenges. Biopsy sampling errors together with less than optimal imaging of tumours can lead to difficulties in selecting suitable low-risk patients for these options. • To overcome these challenges, novel approaches to the staging and monitoring of patients with early prostate cancer are being developed. These include new imaging techniques, such as multi-parametric magnetic resonance imaging, and the development of new biomarkers and biopsy-based methods. These techniques aim to assess the potential of a specific tumour to be aggressive, and to improve patient outcomes. • The aim of the present paper is to summarise presentations and debates at the third annual Interactive Genitourinary Cancer Conference concerning the use of population-based screening methods and the roles of active surveillance and focal therapy as prostate cancer treatments. The application of novel imaging biopsy-based methods and biomarkers in early-stage prostate cancer will also be explored. more...

Diagnosis of human bladder cancer in untreated tissue sections is achieved by using imaging data from desorption electrospray ionization mass spectrometry (DESI-MS) combined with multivariate statistical analysis. We use the distinctive DESI-MS glycerophospholipid (GP) mass spectral profiles to visually characterize and formally classify twenty pairs (40 tissue samples) of human cancerous and adjacent normal bladder tissue samples. The individual ion images derived from the acquired profiles correlate with standard histological hematoxylin and eosin (H&E)-stained serial sections. The profiles allow us to classify the disease status of the tissue samples with high accuracy as judged by reference histological data. To achieve this, the data from the twenty pairs were divided into a training set and a validation set. Spectra from the tumor and normal regions of each of the tissue sections in the training set were used for orthogonal projection to latent structures (O-PLS) treated partial least-square discriminate analysis (PLS-DA). This predictive model was then validated by using the validation set and showed a 5% error rate for classification and a misclassification rate of 12%. It was also used to create synthetic images of the tissue sections showing pixel-by-pixel disease classification of the tissue and these data agreed well with the independent classification that uses histological data by a certified pathologist. This represents the first application of multivariate statistical methods for classification by ambient ionization although these methods have been applied previously to other MS imaging methods. The results are encouraging in terms of the development of a method that could be utilized in a clinical setting through visualization and diagnosis of intact tissue. more...

OBJECTIVE To report the long-term outcome of high-grade prostate cancer treated with radical prostatectomy (RP) as initial monotherapy, analyse the effect of clinical and pathological variables on survival, and report cancer-related symptoms. PATIENTS AND METHODS A retrospective chart review was conducted to identify patients with Gleason 8-10 prostate cancer found on pathological review in men undergoing RP as initial therapy for clinically localized disease between 1988 and 2005. Kaplan-Meier analysis was used to calculate event-free survival. Univariable and multivariable analyses were used to assess the effects of clinical and pathological variables on prostate-specific antigen (PSA) recurrence. RESULTS After excluding 20 patients, 119 were identified with pathologically confirmed high-grade cancers at the time of RP. The overall median (interquartile range) follow-up was 73 (41-113) months. Twenty-four (20%) patients had organ-confined cancer, 60 (50%) had specimen-confined cancer, and 14 (12%) had nodal metastasis. Kaplan-Meier analysis showed overall survival rates at 5 and 10 years, respectively, of 90% and 75%, cancer-specific survival of 92% and 82%, and a PSA recurrence-free follow-up at 5 years of 31%. Using univariable analysis, preoperative PSA level, pathological Gleason score, pathological stage, surgical margin status and tumour volume were found to significantly affect the PSA recurrence-free follow-up. No variables were significant on multivariable analysis. Cancer-related symptoms were reported by only 14 patients, with a median time from surgery to first symptom of 43 months. CONCLUSION High-grade prostate cancer can be treated with RP as initial monotherapy with an acceptable 10-year cancer-specific survival (82%). The PSA recurrence-free follow-up is poor (31% at 5 years). However, few patients progress to symptomatic recurrence after PSA relapse within the first 5 years. more...

Aims: Patients who have undergone intestinal augmentation cystoplasty are at risk for developing latent vesicle malignancy. The aim was to evaluate the histological and immunohistochemical characteristics and molecular genetic alterations in these neoplasms. Methods and results: Four patients developing urothelial neoplasms after augmentation cystoplasty were included in the current study. The mean age of the patients, including two men and two women, was 37 years. The latency from bladder augmentation to developing malignancy ranged from 17 to 21 years (mean 19 years). All patients died of cancer shortly after diagnosis (mean 5 months). In the morphological evaluation, all tumours were high-grade (grade 3) invasive urothelial carcinoma comprising various architectural patterns with brisk mitoses and tumour necrosis. Three harboured glandular differentiation and the remaining one showed squamous differentiation. All cases revealed abnormal decreasing β-catenin expression. Two tumours showed nuclear expression of CDX2. On UroVysion fluorescence in situ hybridization (FISH) analysis, all tumours displayed characteristic chromosomal abnormalities. Point mutations of both FGFR3 and p53 genes were identified in one case. Conclusions: Urothelial carcinomas developed after augmentation cystoplasty are extremely aggressive and exhibit distinct morphological, immunohistochemical and genetic characteristics. UroVysion FISH analysis may offer a surveillance strategy in patients who undergo augmentation cystoplasty. more...

A long-term female hemodialysis patient with end-stage renal disease due to Wegener's granulomatosis (WG) experienced a severe relapse when immunosuppressive therapy was switched from prednisone and cyclophosphamide to azathioprine maintenance therapy. Ten courses of protein A immunoadsorption therapy and switching immunosuppressive therapy to mycophenolate mofetil have proved to be very successful and free of side effects. The patient has fully recovered from all clinical WG symptoms and is still in remission ten months after the treatment. more...

Identification of reliable non-invasive markers for the detection of invasive phenotype of urothelial carcinoma is needed. This study characterizes and compares protein expression profiles of adjacent non-neoplastic urothelium and invasive urothelial carcinoma to identify biomarkers for early detection of de novo bladder cancer. Differences in protein expression between adjacent non-neoplastic and high-grade, stage T4, grade 3 invasive urothelial carcinoma tissues were investigated using 2-DE, MALDI-TOF-MS, and data processing. Ingenuity Pathway Analysis (IPA) was applied to examine the biological mechanisms represented by the altered proteins. The 2-DE of the adjacent non-neoplastic urothelium and invasive urothelial carcinoma showed reproducibly similar proteomic mapping for each group distinguishing adjacent non-neoplastic urothelium from invasive urothelial carcinoma. Twenty-one proteins were altered in expression and one of these proteins, Choroideremia-like protein (CHML) was significantly overexpressed (p more...

OBJECTIVE To investigate the relationship of preoperative prostate-specific antigen (PSA) level and PSA density with several clinical and pathological variables, including biochemical recurrence after radical prostatectomy (RP), and to compare the preoperative PSA level and PSA density as prognostic factors in prostate cancer. PATIENTS AND METHODS The study included 348 patients who had a RP at one institution, with whole-mount specimens of the prostate examined by one pathologist. Univariate and multivariate analyses were used to assess the relationship of the preoperative PSA level and PSA density with clinical and pathological variables, and by receiver operating characteristic (ROC) analysis to evaluate the relative usefulness of the two factors as predictors for biochemical recurrence. RESULTS The PSA level before RP was significantly correlated (Spearman's rank correlation) with patient age (P = 0.003), prostate weight (P more...

BACKGROUND The Gleason grading system uniquely combines data from different areas of carcinoma in the same prostate specimen. Prostatic adenocarcinoma often is multifocal, and different Gleason grades may be present in different foci. The current study was undertaken to compare the Gleason grades of individual adenocarcinoma foci in a given specimen with the overall Gleason grades (primary and secondary) of that specimen. METHODS Data were obtained from 115 consecutive radical prostatectomy specimens via whole-mount processing and complete sectioning. Diagrams were constructed by tracing the outline of each whole-mount section, and tumor maps subsequently were generated. The largest focus was considered the index tumor. Each prostatectomy specimen was assigned primary and secondary Gleason grades, and each tumor focus was assigned its own primary and secondary Gleason grades. Tumor volume was measured using the grid method. RESULTS Two or more adenocarcinoma foci were present in 87% of all specimens (2 foci, n = 20; 3 foci, n = 33; 4 foci, n = 17; 5 foci, n = 13; > 5 foci, n = 17). Specimens (n = 15) containing a single tumor were excluded from further analysis. Among the remaining specimens (n = 100), all tumor foci had Gleason grades that were the same as the corresponding overall Gleason grades in only 9 cases (9%). The Gleason score (i.e., the sum of the primary and secondary grades) of the index tumor was correlated with the overall Gleason score in 68% of specimens. The primary grade of the index tumor was the same as the overall primary grade in 97 specimens, whereas the secondary grade of the index tumor was the same as the overall secondary grade in only 68 specimens. The primary and secondary grades of the index tumor, compared with the overall Gleason primary and secondary grades, were reversed in 17 specimens. CONCLUSIONS The findings of the current study demonstrated the histologic heterogeneity of multifocal prostate malignancies. Although the Gleason grading system was used to determine an overall score for prostate carcinoma within a specimen, the scores of individual tumors, including index tumors, often did not agree with this overall score. These findings may have implications with respect to future biomarker and tissue array studies. Cancer 2004. © 2004 American Cancer Society. more...

BACKGROUND Urothelial carcinoma commonly manifested loss of heterozygosity (LOH) at different regions of chromosomes 17p, 3p, and 9q. Recent studies suggested that bladder stromal cells may be implicated in the growth and progression of urothelial carcinoma. To better understand the genetic alterations in the stromal cells in patients with bladder carcinoma, the authors evaluated the prevalence of allelic loss at three microsatellite polymorphic markers on chromosomes 17p13 (TP53), 3p25-26 (D3S3050), and 9q32-33 (D9S177). In addition, the pattern of X-chromosome inactivation of the stromal cells was evaluated by analyzing the DNA methylation pattern at a polymorphic site on the androgen receptor gene. METHODS The authors studied 18 female patients who underwent either transurethral resection (n = 2) or radical cystectomy (n = 16) for high-grade muscle-invasive urothelial carcinoma of the urinary bladder. Genomic DNA samples from the stromal cells immediately adjacent to the tumor and the tumor itself were prepared from formalin-fixed, paraffin-processed tissues using laser-assisted microdissection and LOH was determined. RESULTS The stromal cells showed a high frequency of LOH on chromosomes 17p13 (29%), 3p25-26 (61%), and 9q32-33 (47%) with no clear concordance with the adjacent tumor cells. Fourteen specimens (78%) showed LOH in the stroma in at least 1 of 3 markers examined. Nonrandom X-chromosome inactivation was frequent in the stromal cells (50% of informative specimens). CONCLUSIONS The current study revealed that some of the genetic changes that commonly occur with invasive urothelial carcinoma were frequently found in the adjacent stroma and suggested that the stroma of urothelial carcinoma may play an important role in bladder carcinogenesis. Cancer 2003. © 2003 American Cancer Society. more...

In the Urological Oncology section this month, there are seven original articles, dealing with two subjects: prostate cancer and testicular cancer. They come from a variety of countries, in order of appearances, as it were: the USA, Israel, Turkey, UK and Italy. The authors from Indianapolis examine their experience with radical prostatectomy in patients with a serum PSA of 20–100 ng/mL, a group which might be considered by many to be unsuitable for such an operation. This is a controversial subject and there are two editorial comments at the end of the article. The authors found that not surprisingly cancer-free survival is not as good as in patients with a lower PSA level, but they felt that biochemical disease-free survival could be achieved. The authors from Israel found that colour-Doppler ultrasonography is helpful in detecting perineural invasion, and thus in predicting histologically localised prostate cancer. The papers on testicular cancer are also controversial, examining several issues relating to seminomatous and nonseminomatous germ cell tumours. There is a comment at the beginning of this issue of the journal which is devoted to some of these papers. OBJECTIVE To examine our experience with radical prostatectomy (RP) in patients with a serum prostate-specific antigen (PSA) level of > 20 ng/mL (who are sometimes considered poor candidates for RP) to determine the outcome and possible predictors of a favourable outcome. PATIENTS AND METHODS We retrospectively reviewed the medical records of 79 patients who underwent RP with an initial PSA of 20–100 ng/mL. Biochemical disease-free survival (BDFS) was assessed using the Kaplan-Meier method and predictors of treatment outcome examined by uni- and multivariate analysis. Patients excluded from the analysis were 11 (14%) whose surgery was aborted after finding cancerous pelvic nodes and who did not undergo RP; four others with normal nodes during RP who had metastatic tumour on permanent sections; and 14 who had follow-up data for < 2 years. RESULTS The mean (sd) age of the 50 patients in the final study population was 63 (7) years and the mean PSA 37.9 (16.0) ng/mL. The median (range) follow-up was 54 (24–120) months. The BDFS was 60% at 3 years and 48% at 5 years of follow-up. Two patients developed a local recurrence and eight developed metastatic disease. On logistic regression analysis of factors influencing BDFS, only extracapsular extension of disease was predictive of PSA recurrence; no preoperative factor was significant. When time to PSA recurrence was assessed by Cox regression analysis, again only extracapsular extension was predictive, with no preoperative variable a statistically significant predictor. CONCLUSIONS Patients with a high serum PSA level (20–100 ng/mL) may be appropriate candidates for RP. While the cancer-free survival is not as good as in patients with a lower PSA, a significant percentage of patients achieve BDFS. No preoperative variables were predictive of disease-free survival or time to PSA recurrence. more...

BACKGROUND Some evidence suggests a role for HER-2/neu overexpression in prostate carcinoma progression. Reported rates of HER-2/neu overexpression in patients with prostate carcinoma vary greatly. METHODS The authors studied radical prostatectomy specimens from 38 patients who had biochemical failure after undergoing radical prostatectomy for prostate carcinoma. Immunohistochemistry for HER-2/neu overexpression using the HercepTest kit (Dako Corporation, Carpenteria, CA) was employed. Two different antigen-retrieval techniques were used: 1) the standard U.S. Food and Drug Administration (FDA)-approved HercepTest assay and 2) a modified HercepTest, which employed an alkaline citrate buffer, pH 9.0, for antigen retrieval and a 1-hour primary antibody incubation time. The level of HER-2/neu expression was evaluated on a scale from 0 (no staining) to 3+ according to the published guidelines. Fluorescent in situ hybridization for gene amplification was performed on all specimens. RESULTS With the standard technique, only one specimen had 2+ staining, and no specimens had 3+ staining. With the modified technique, 10 specimens (26%) had 2+ staining, and 9 specimens (24%) had 3+ staining. There was a significant association between the level of HER-2/neu expression shown with the modified technique and tumor stage (P = 0.03) as well as Gleason grade (P = 0.01). None of the specimens had HER-2/neu gene amplification. CONCLUSIONS The authors report a simple modification of the HercepTest that resulted in an increased rate of HER-2/neu expression, which was correlated with poor-risk pathologic findings. The findings suggest that adenocarcinoma of the prostate should be evaluated for HER-2/neu expression with a prostate specific immunohistochemical procedure that differs from the FDA-approved standard procedure. Cancer 2002;95:1650–5. © 2002 American Cancer Society. DOI 10.1002/cncr.10839 more...

Objective: Minimally invasive techniques have an increasing relevance for the treatment of sialolithiasis of the parotid and submandibular glands. Sialendoscopy can be used as both a diagnostic and therapeutic tool.Method: Retrospective data analysis for patients with a sialolithiasis of the parotid and submandibular glands who were treated between 2002 and 2008.Results: A total of 206 patients were treated because of sialolithiasis of the parotid gland, 98 (48%) by interventional endoscopy alone, and 108 (52%) by combined procedures. Patients with submandibular disease (736) were treated endoscopically alone in 7.5% (55); 92.5% (681) received a combined treatment together with sialendoscopy. The follow-up showed that 93% of the patients treated with endoscopy alone were free of symptoms. In the combined group 90% and 79% of the patients with sialolithiasis of the submandibular glands and parotid glands respectively were free of symptoms.Conclusion: Sialendoscopy is an important diagnostic and therapeutic... more...

Objective: Nonsurgical therapies, which utilize combinations of chemotherapy and radiotherapy, have become popular treatments for early oropharyngeal carcinomas (OPC). The aim of this study is to analyze the outcome of primary definitive surgical management of patients with limited OPC and assess the influence of various prognostic factors in survival.Method: A retrospective study was conducted between 1980 and 2007. A total of 266 surgically treated patients were included. The endpoints for the analysis were disease-specific survival (DSS) and local control (LC), with respect to T- and N-classification, status of margins, tumor depth, and type of treatment. Major complications were documented.Results: Overall 5-year DSS was 89.9% and LC 93.3%. The univariate analysis showed a significant difference in DSS between pT1 and pT2 OPC (DSS 94.0% vs 81.2%, P = .008) and patients with tumor depth greater than 5 mm (DSS 94.5% vs 78.9%, P = .031). No difference could be found according to N-stage, marginal status,... more...

The human environment consists of a large variety of mechanical and biomechanical systems in which different types of contact can occur. In this work, we consider a monopedal jumper modelled as a three-dimensional rigid multibody system with contact and simulate its dynamics using a structure preserving method. The applied mechanical integrator is based on a constrained version of the Lagranged’Alembert principle. The resulting variational integrator preserves the symplecticity and momentum maps of the multibody dynamics. To ensure the structure preservation and the geometric correctness, we solve the non-smooth problem including the computation of the contact configuration, time and force instead of relying on a smooth approximation of the contact problem via a penalty potential. In addition to the formulation of non-smooth problems in forward dynamic simulations, we are interested in the optimal control of the monopedal high jump. The optimal control problem is solved using a direct transcription method transforming it into a constrained optimisation problem, see [14]. more...

This work considers the optimal control of multibody systems being actuated with control forces which impact the system's motion directly. The goal is to find a dynamically feasible trajectory of states and control leading from an initial to a desired final state, while minimising an objective function. The optimal control problem is solved using a direct transcription method, i.e. boundary conditions and a discrete version of the equations of motion serve as constraints for the minimisation of a cost function with respect to the discrete state and control trajectory. Here, a particular time stepping scheme, an energy momentum integrator based on discrete derivatives is used. Corresponding to a constrained formulation of multibody systems, we develop an energy momentum consistent discrete force formulation that fits into the energy momentum integrator. (© 2010 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim) more...