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Knowledge about anatomical details seems to facilitate the procedure and planning of prostatic artery embolization (PAE) in patients with symptomatic benign prostatic hyperplasia (BPS). The aim of our study was the pre-interventional visualization of the prostatic artery (PA) with MRA and the correlation of iliac elongation and bifurcation angles with technical success of PAE and technical parameters. MRA data of patients with PAE were analysed retrospectively regarding PA visibility, PA type, vessel elongation, and defined angles were correlated with intervention time, fluoroscopy time, dose area product (DAP), cumulative air kerma (CAK), contrast media (CM) dose and technical success of embolization. T-test, ANOVA, Pearson correlation, and Kruskal-Wallis test was applied for statistical analysis. MRA identified the PA origin in 126 of 147 cases (accuracy 86%). Vessel elongation affected time for catheterization of right PA (p = 0.02), fluoroscopy time (p = 0.05), and CM dose (p = 0.02) significantly. Moderate correlation was observed for iliac bifurcation angles with DAP (r = 0.30 left; r = 0.34 right; p = 0.01) and CAK (r = 0.32 left; r = 0.36 right; p = 0.01) on both sides. Comparing the first half and second half of patients, median intervention time (125 vs. 105 min.) and number of iliac CBCT could be reduced (p

ZusammenfassungDie radikale Prostatektomie (RP) als offener, laparoskopischer oder robotergestützter Eingriff stellt nach wie vor den kurativen „Goldstandard“ für Patienten mit einem lokal begrenzten Prostatakarzinom dar. Heutzutage wird die RP zudem als Erstbehandlung für ein lokal fortgeschrittenes Prostatakarzinom, eventuell im Rahmen eines multimodalen Settings mit adjuvanter Strahlen-/Hormontherapie angewendet. Die zunehmende Erfahrung der Chirurgen, die bessere Kenntnis der Anatomie und die Verfeinerungen der Operationstechniken haben die onkologischen sowie funktionellen Ergebnisse immens verbessert. In unserem Artikel möchten wir einen Überblick über die mit der Operation verbundenen Komplikationen geben.

BACKGROUND Surgical site infections (SSI) are frequent hospital acquired complications. Ongoing surveillance pro-grams evaluate the incidence of SSI worldwide. However, incidence rates are only estimated by the analyses of indicator procedures to date. OBJECTIVE To further assess procedure specific SSI rates, the harmonization of international procedure codes is necessary. METHODS We compared existing surgical procedure coding systems of five European countries (France, Ger-many, Italy, Spain, and the UK) and distributed a simplified code to all existing country-specific codes. Based on mode and extent of the surgical procedure and the surgical site, 153 codes were defined, distributed, and characterized within the presented coding system. Additionally, minimally invasive, laparoscopic or open surgical approaches were considered, whereas eye surgery and di-agnostic procedures were excluded. RESULTS A total number of 15432 surgical procedures were assigned to 153 SALT codes from 10 specialties. Almost 4000 (26%) procedure codes from the SALT coding system were classified as orthopaedic and trauma surgeries, thus this medical field represents the most diverse group within the SALT coding system, followed by abdominal surgical procedures with 2390 (15%) procedure codes. CONCLUSIONS The Europe-wide SALT procedure code gives the opportunity to harmonize big data sets containing surgical procedures from international centres, and may simplify comparability of future interna-tional trial findings.

Radical prostatectomy (RP), performed as an open, laparoscopic or robotic procedure, remains the "gold standard" for patients with localised prostate cancer who can be cured with surgery and have a life expectancy of at least 10 years. Today, RP is also used as a first-line treatment for locally advanced prostate cancer, possibly in a multimodal setting with adjuvant radiation/hormonal therapy. The increasing experience of surgeons, better knowledge of anatomy and refinements of surgical techniques have greatly improved oncological and functional outcomes. In our article we would like to give an overview of the complications associated with this surgical procedure.Die radikale Prostatektomie (RP) als offener, laparoskopischer oder robotergestützter Eingriff stellt nach wie vor den kurativen „Goldstandard“ für Patienten mit einem lokal begrenzten Prostatakarzinom dar. Heutzutage wird die RP zudem als Erstbehandlung für ein lokal fortgeschrittenes Prostatakarzinom, eventuell im Rahmen eines multimodalen Settings mit adjuvanter Strahlen-/Hormontherapie angewendet. Die zunehmende Erfahrung der Chirurgen, die bessere Kenntnis der Anatomie und die Verfeinerungen der Operationstechniken haben die onkologischen sowie funktionellen Ergebnisse immens verbessert. In unserem Artikel möchten wir einen Überblick über die mit der Operation verbundenen Komplikationen geben.

Prostatakrebs ist die haufigste Krebsart bei Mannern in den Industrielandern. Die jahrliche Neuerkrankungsrate in Deutschland betragt ca. 60.000. Jahrlich sterben 13.000 Manner an dieser Erkrankung. Dennoch ist die 10-Jahres-Uberlebensrate im Vergleich zu anderen Karzinomen relativ gunstig. Die Prostatakrebsfruherkennung bzw. das Prostatakrebsscreening werden national wie international kontrovers diskutiert. Dies ist bedingt durch die Tatsache, dass durch die Bestimmung des prostataspezifischen Antigens (PSA) zur Tumorsuche seit den 1980er-Jahren eine Uberdiagnostik von klinisch insignifikanten Prostatakarzinomen stattgefunden hat, die zu einer Ubertherapie – meist durch eine operative radikale Prostatektomie oder Strahlentherapie – fuhrte. Diese Ubersichtsarbeit soll die bisher grosten randomisiert kontrollierten Studien zum PSA-basierten Prostatakrebsscreening sowie Vor- und Nachteile dieses Screenings beleuchten und einen Ausblick auf Entwicklungen zukunftiger Strategien zur Prostatakrebsfruherkennung geben. Die ERSPC-Studie (European Randomized Study for Screening of Prostate Cancer) zeigte fur das PSA-basierte Prostatakrebsscreening eine relative Reduktion der prostatakrebsspezifischen Mortalitat um etwa 21 % nach einer medianen Nachbeobachtungszeit von 13 Jahren. Bei einem populationsbezogenen Screening wurden aber in absoluten Zahlen nur relativ wenige Manner profitieren und die Rate an Uberdiagnosen bliebe hoch. Das Vorgehen in einer schwedischen Langzeitstudie, in der anhand der Bestimmung eines Basis-PSA-Wertes im Alter von ca. 40–50 Jahren nachfolgend risikoadaptierte Screeningintervalle angewandt wurden, zeigte vielversprechende Ergebnisse und konnte gegebenenfalls einen Losungsansatz fur dieses Dilemma darstellen. Diese Strategie ist Grundlage der aktuell grosten Studie zum risikoadaptierten Prostatakrebsscreening ( www.PROBASE.de ), die dieses Konzept erstmals mit einem randomisierten Design evaluiert.

Eine Einladung zu einem einzelnen PSA-Test fuhrt bei Mannern uber 50 Jahren zwar zu einer Haufung von Prostatakrebsdiagnosen, hat aber keinen Einfluss auf die Sterberate. Das liegt wohl auch daran, dass die meisten Manner die Einladung nicht annehmen.

Prostate cancer is the most common cancer among men in industrialized countries. The annual incidence rate in Germany is about 60,000. Every year, 13,000 men die of this disease. Nevertheless, the 10-year survival rate is relatively favorable compared to other carcinomas.Prostate cancer screening is discussed controversially both nationally and internationally. This is due to the fact that the determination of the prostate-specific antigen (PSA) for tumor detection beginning in the 1980s led to over-diagnosis of clinically insignificant prostate cancer and consequently to over-therapy-usually by radical prostatectomy or radiotherapy.This review article will discuss the largest randomized controlled trials of PSA-based prostate cancer screening to date. It will highlight the advantages and disadvantages of this screening and give an outlook on the development of future strategies for prostate cancer screening.For PSA screening, the European Randomized Study for Screening of Prostate Cancer (ERSPC) study showed a relative reduction in prostate cancer-specific mortality of approximately 21% after a median follow-up period of 13 years. However, in absolute figures, relatively few men will benefit from population-based screening and the rate of over-diagnosed men remains high.The procedure in a Swedish long-term study, in which risk-adapted screening intervals were applied on the basis of the assessment of a baseline PSA level at a young age (40-50) showed promising results and may provide a solution to this dilemma. This strategy is the basis for the currently largest study on risk-adapted prostate cancer screening ( www.PROBASE.de ), which evaluates this concept for the first time with a randomized design.

The organic cation transporter 3 (OCT3) is a widely expressed transporter for endogenous and exogenous organic cations. Of particular interest is OCT3 expression and function in the brain, where it plays a role in serotonin clearance and influences mood and behavior. Protein kinase signaling mediates rapid modulation of cerebral processes, but little is known about acute regulation of OCT3 by protein kinases. Therefore, we cloned mouse OCT3 (mOCT3) and generated a human embryonic kidney cell line stably expressing the transporter to study transport characteristics, acute regulation by protein kinases, and interaction with psychotropic drugs. Uptake measurement was performed using the fluorescent cation 4-(4-(dimethylamino)styryl)-N-methylpyridinium iodide (ASP+, 1 μM) as a substrate. The translational value of these findings was determined by comparing results obtained with cloned mouse and human OCT3. mOCT3-mediated transport is membrane potential dependent and pH independent. ASP+ uptake by mOCT3 and human OCT3 (hOCT3) was efficiently inhibited by 1-methyl-4-phenylpyridinium, tetrapentylammonium (TPA+), corticosterone, serotonin, and histamine and by the drugs ketamine, fluoxetine, and diazepam. The half maximal inhibitory concentrations of mOCT3 and hOCT3 for TPA+, serotonin, diazepam, and ketamine are significantly different. Diazepam is a non-transported inhibitor. Furthermore, the activities of mOCT3 and hOCT3 are acutely regulated by the p56 lck tyrosine kinase by decreasing their V max. Studies with freshly isolated renal proximal tubules from mOCT1/2−/− mice, in which mOCT3 is the only OCT present, confirmed this regulation pathway. Only the activity of hOCT3 is regulated by calmodulin. These findings suggest that even though many transport properties of mOCT3 and hOCT3 are similar, there are also species-specific aspects of OCT3 function.

Polyspecific organic cation transporter Oct2 from rat (gene Slc22A2) has been previously shown to transport Cs(+). Here we report that human OCT2 (hOCT2) is able to transport Cd(2+) showing substrate saturation with a Michaelis-Menten constant (Km) of 54 ± 5.8 μM. Uptake of Cd(2+) by hOCT2 was inhibited by typical hOCT2 ligands (unlabeled substrates and inhibitors), and the rate of uptake was decreased by a point mutation in a substrate binding domain of hOCT2. Incubation of hOCT2 overexpressing human embryonic kidney 293 cells (HEK-hOCT2-C) or rat renal proximal tubule cells expressing rOct2 (NRK-52E-C) with Cd(2+) resulted in an increased level of apoptosis that was reduced by OCT2 inhibitory ligand cimetidine(+). HEK-hOCT2-C exhibited different functional properties when they were confluent or had been dissociated by removal of Ca(2+) and Mg(2+). Only confluent HEK-hOCT2-C transported Cd(2+), and confluent and dissociated cells exhibited different potencies for inhibition of uptake of 1-methyl-4-phenylpyridinium(+) (MPP(+)) by Cd(2+), MPP(+), tetraethylammonium(+), cimetidine(+), and corticosterone. In confluent HEK-hOCT2-C, largely different inhibitor potencies were obtained upon comparison of inhibition of Cd(2+) uptake, 4-[4-(dimethylamino)styryl]-N-methylpyridinium(+) (ASP(+)) uptake, and MPP(+) uptake using substrate concentrations far below the respective Km values. Employing a point mutation in the previously identified substrate binding site of rat Oct1 produced evidence that short distance allosteric effects between binding sites for substrates and inhibitors are involved in substrate-dependent inhibitor potency. Substrate-dependent inhibitor affinity is probably a common property of OCTs. To predict interactions between drugs that are transported by OCTs and inhibitory drugs, it is necessary to employ the specific transported drug rather than a model substrate for in vitro measurements.