Lymphadenectomy in Bladder Cancer

Pelvic lymphadenectomy is widely accepted as an essential part of radical cystectomy. It provides important information (number of lymph nodes involved, tumor volume, capsular perforation) for prognosis, which may help identify patients at increased risk for progression. More important, there is a growing body of evidence indicating that meticulous, extended pelvic lymphadenectomy may cure a substantial number of patients who would otherwise develop local recurrences or distant metastases. Furthermore, extended bilateral lymph node dissection facilitates cystectomy, makes it safer to perform and does not substantially alter morbidity of the operation.     

Microstructure and long-term stability of solder joints on nickel-plated aluminium formed during short soldering times

Within this work, we demonstrate that an easy soldering process in combination with wet chemical coating is suitable to realize a strong and reliable solder interconnection of Al substrates, even at short soldering times <5 s in ambient air. The microstructure of solder joints on wet chemically treated aluminum foils is investigated. A single and double zincate pre-treatment are compared to activate the Al surface, followed by electroless Ni plating. The quality of the solderable Ni surface is characterized by contact angle measurements, yielding good wettability (<60°), which is also achieved after isothermally heating (250 °C) the Ni-coated Al foils for 100 min. The microstructure of the Sn62Pb36Ag2 solder joints is investigated by SEM and EDX of cross sections, directly after soldering as well as after isothermal aging at 85 °C. Under the used soldering conditions, with a soldering temperature at about 280 °C, diffusion zones <500 nm were identified. Nonetheless, high peel forces after soldering >5 N mm⁻¹ show stable values under aging conditions of 85 °C for 1000 hours. This could be correlated to a mixed fracture pattern, promoting the high adhesion due to the absence of a dominant failure mechanism.

High mechanical reliability of tin-based solder joints processed by joining copper and nickel-coated aluminium with short soldering times in ambient air.     

Efficacy of SpyGlass~(TM)-directed biopsy compared to brush cytology in obtaining adequate tissue for diagnosis in patients with biliary strictures

AIM: To evaluate the diagnostic yield(inflammatory activity) and efficiency(size of the biopsy specimen) of SpyGlassTM-guided biopsy vs standard brush cytology in patients with and without primary sclerosing cholangitis(PSC).METHODS: At the University Medical Center Mainz, Germany, 35 consecutive patients with unclear biliarylesions(16 patients) or long-standing PSC(19 patients) were screened for the study. All patients underwent a physical examination, lab analyses, and abdominal ultrasound. Thirty-one patients with non-PSC strictures or with PSC were scheduled to undergo endoscopic retrograde cholangiography(ERC) and subsequent per-oral cholangioscopy(POC). Standard ERC was initially performed, and any lesions or strictures were localized. POC was performed later during the same session. The Boston Scientific SpyGlass SystemTM(Natick, MA, United States) was used for choledochoscopy. The biliary tree was visualized, and suspected lesions or strictures were biopsied, followed by brush cytology of the same area. The study endpoints(for both techniques) were the degree of inflammation, tissue specimen size, and the patient populations(PSC vs non-PSC). Inflammatory changes were divided into three categories: none, low activity, and high activity. The specimen quantity was rated as low, moderate, or sufficient.RESULTS: SpyGlassTM imaging and brush cytology with material retrieval were performed in 29 of 31(93.5%) patients(23 of the 29 patients were male). The median patient age was 45 years(min, 20 years; max, 76 years). Nineteen patients had known PSC, and 10 showed non-PSC strictures. No procedure-related complications were encountered. However, for both methods, tissues could only be retrieved from 29 pa-tients. In cases of inflammation of the biliary tract, the diagnostic yield of the SpyGlassTM-directed biopsies was greater than that using brush cytology. More tissue material was obtained for the biopsy method than for the brush cytology method(P = 0.021). The biopsies showed significantly more inflammatory characteristics and greater inflammatory activity compared to the cy-tological investigation(P = 0.014). The greater quantity of tissue samples proved useful for both PSC and non-PSC patients.CONCLUSION: SpyGlassTM imaging can be recom-mended for proper inflammatory diagnosis in PSC pa-tients. However, its value in diagnosing dysplasia wasnot addressed in this study and requires further investi-gation.     

Up-regulation of gonadotropin mRNA-expression at the onset of gametogenesis in the roach (Rutilus rutilus): Evidence for an important role of brain-type aromatase (cyp19a1b) in the pituitary

The present study characterized changes in key parameters of reproduction in adult roach (Rutilus rutilus) from Lake Grosser Mueggelsee (Berlin, Germany) during natural gametogenesis. Fish of both sexes were sampled in monthly intervals between April and August in order to cover the onset of gametogenesis. Investigated parameters included gonad histology, plasma levels of 17β-oestradiol (E2), testosterone (T), 11-ketotestosterone (11-KT), and 17,20β-dihydroxy-4-pregnen-3-one (17,20β-P) as well as the expression of gonadotropin subunits in the pituitary. Furthermore, the mRNA-expression of brain-type aromatase (cyp19a1b), androgen receptor (ar), and estrogen receptor isoforms was studied at the pituitary level. The onset of gametogenesis - as indicated by follicles with cortical alveoli in females and first spermatogonia B in males - was observed in July, accompanied by a significant up-regulation of follicle-stimulating hormone β (fshβ) mRNA in the pituitary in both sexes. On the other hand, luteinizing hormone β (lhβ) mRNA increased later on in August. In males, the increase of fshβ mRNA in July coincided with a rise in plasma 11-KT concentrations. In females, E2 in plasma increased later, not until August, shortly before true vitellogenesis (late cortical alveoli stage). Expression of sex steroid receptors in the pituitary revealed only minor seasonal fluctuations. Most pronounced, ar mRNA displayed the highest level pre-spawning in both sexes. Interestingly, cyp19a1b mRNA-expression in the pituitary increased in parallel with fshβ already before any changes in plasma E2 or T occurred. These data suggest an important role of pituitary FSH and aromatase at the onset of gametogenesis in the roach.