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We present a new model of the near‐Earth magnetospheric field produced by electric currents in the inner magnetosphere and the associated induced magnetic field. The model is designed to track hourly variations of these fields and accounts for their local time asymmetries. It is built by applying spherical harmonic analysis to vector measurements from the ground observatory network at low and mid‐latitudes. The primary and induced fields are separated with an approach in the time domain that uses a a priori radially‐symmetric electric conductivity model of the Earth. The model coefficients are computed at one‐hour time steps between 1997 and 2022. This model is shown to be consistent to within a few nT with previously developed indices which track the magnetospheric ring current. It is also validated against data from the Swarm, CHAMP and Øersted satellites. The fit to satellite data is comparable to that of the CHAOS‐7.15 model for geomagnetically quiet times, and improved by up to 20% on some components for geomagnetically moderate and active times. We attribute these differences mostly to a better representation of local time asymmetries, both on average and during individual geomagnetic storms. This model can be used in various applications, such as investigating the properties of the magnetospheric field and its sources and separating the magnetospheric field from the fields of other sources in geomagnetic field modeling. Plain Language Summary: Geomagnetic field modeling aims at building data‐based mathematical representations, or models, of the various contributions to the total Earth's magnetic field measured at or near the Earth's surface. One of such contributions is the magnetic field generated by electric currents in the inner magnetosphere, including the so‐called ring current. In this paper, we present a new model of the near‐Earth magnetic field generated in the inner magnetosphere based on data collected in ground magnetic observatories. The model covers the 1997–2022 time span, includes improved representations of the local time asymmetries of the field and of the effect of electrical induction in the Earth's mantle, and is validated against data collected in low Earth orbits by the Swarm, CHAMP and Oersted satellites. We find that the model provides an improved representation of the magnetic field generated in the inner magnetosphere during periods of moderate and high geomagnetic activity, including magnetic storms. Key Points: A new ground‐data based model of hourly variations of the primary inner near‐Earth magnetospheric and associated induced field is presentedComparison with satellite data shows up to 20% performance improvement compared to the CHAOS‐7 model for moderate and active timesThe model accounts for variations of the field with local time and can be used to study geomagnetic storms [ABSTRACT FROM AUTHOR]

We present a new empirical model of quiet‐time F‐region ionospheric currents and associated magnetic fields. This model is designed to accurately represent these currents and fields at low and mid latitudes. For each individual Swarm satellite, the preprocessed data is represented as a non‐potential toroidal magnetic field using the Mie representation in a thin‐shell and spherical harmonic expansions. This approach allows to fully separate spatial and climatological variations as well as to assess the robustness of the model with respect to both measurement errors and data sampling with local time. The obtained model describes the toroidal magnetic fields and the associated radial poloidal electric currents at two distinct altitudes in the ionosphere F region. Clear signatures of low‐ and mid‐latitude interhemispheric field‐aligned currents (IHFACs) are identified. The model reproduces well‐known characteristics of the climatology of IHFACs and provides new insights, for example, on the average daily variations of IHFACs during winter in the Northern Hemisphere. It also well recovers the variations of IHFACs with longitude. The potential driving mechanisms of these variations, such as longitudinal variations of the main field and modulation by upward propagating atmospheric tides, are discussed. The new model can be used to analyze the relationship between atmospheric tides and IHFACs. It can also be used to investigate the connection between the magnetic fields and electric currents from the ionospheric E and F regions in order to improve the separation of these fields as well as our understanding of the overall ionospheric electric current system. Key Points: A new Swarm‐based model of low‐ and mid‐latitude ionospheric F‐region magnetic fields and electric currents is presentedThe model provides a detailed picture of the climatology of low‐ and mid‐latitude interhemispheric field‐aligned currentsThe model provides constraints on the relationship between interhemispheric field‐aligned currents and upward propagating atmospheric tides [ABSTRACT FROM AUTHOR]

The IGRF is a truly international collaboration, by which multiple teams of magnetic field experts submit candidate model coefficients to improve past model predictions, as well as make forecasts for the next 5 year period. 2021; 73; 46: 1-4. 10.1186/s40623-020-01312-0 14 Ropp G, Lesur V, Baerenzung J, Holschneider M. Sequential modelling of the Earth's core magnetic field. The 13th generation IGRF (IGRF-13), which is the subject of this special issue, provides model coefficients from 1900 to 2025, allowing a description of the geomagnetic field over the past one and one quarter centuries. The large-scale time-varying portion of Earth's internal magnetic field originates from a dynamo process inside the outer core. [Extracted from the article]

We present a new application of a multispacecraft method which provides estimates of the full electric current density vector in the ionospheric low‐ and mid‐latitude F region. The method uses the three satellites of the Swarm constellation in configurations when they were close to each other. The current density is calculated inside triangular prisms defined by the satellite positions. The technique is inspired by similar approaches such as the curlometer. Here, we propose an alternative mathematical treatment, which involves the use of the well‐known curl‐B technique and a least squares minimization. The proposed formalism provides a rigorous way to propagate the errors through the problem and special care is taken to validate the algorithm and assess the relevance of the derived currents. Such techniques are powerful tools to study the F‐region ionosphere currents as they naturally exclude all the other contributions outside the considered volumes. The F region is known to host currents with a complex spatiotemporal variability. Besides the intrinsic interest of this system itself, understanding the dynamics of these currents is also critical for global geomagnetic field modeling as they are an important source of error in the models. In this paper, we present the full algorithm and test the method on both synthetic and real Swarm satellite data on February 15, 2014. Several sources of error are investigated. Additionally, the results reveal expected characteristics of F‐region interhemispheric field‐aligned currents. Some new characteristics of F‐region currents, potentially associated with dynamo and pressure currents, are also observed. Key Points: A new application of a multispacecraft method to derive the three components of the current density in the F‐region ionosphere is presentedAn assessment of the effect of biases and errors on the current density estimates is providedApplication of the method on February 15, 2014 reveals both expected and new characteristics of F‐region currents [ABSTRACT FROM AUTHOR]

Accurate models of the spatial structure of ionospheric magnetic fields in the diurnal variation (DV) band (periods of a few hours to a day) would enable use of magneto-variational methods for 3-D imaging of upper mantle and transition zone electrical conductivity. Constraints on conductivity at these depths, below what is typically possible with magnetotellurics, would in turn provide valuable constraints on mantle hydration and Earths deep water cycle. As a step towards this objective, we present here a novel approach to empirical modelling of global DV magnetic fields. First, we apply frequency domain (FD) principal components analysis (PCA) to ground-based geomagnetic data, to define the dominant spatial and temporal modes of source variability. Spatial modes are restricted to the available data sites, but corresponding temporal modes are effectively continuous in time. Secondly, we apply FD PCA to gridded surface magnetic fields derived from outputs of the physics-based Thermosphere–Ionosphere–Electrodynamics General Circulation Model (TIEGCM), to determine the dominant modes of spatial variability. The TIEGCM spatial modes are then used as basis functions, to fit (or interpolate) the sparsely sampled data spatial modes. Combining the two steps, we have a FD model of DV band global magnetic fields that is continuous in both space and time. We show that the FD model can easily be transformed back to the time domain (TD) to directly fit time-series data, allowing the use of satellite, as well as ground-based, data in the empirical modelling scheme. As an illustration of the methodology we construct global FD and TD models of DV band source fields for 1997–2018. So far, the model uses only ground-based data, from 127 geomagnetic observatories. We show that the model accurately reproduces surface magnetic fields in both active and quiet times, including those at sites not used for model construction. This empirical model, especially with future enhancements, will have many applications: improved imaging of electrical conductivity, ionospheric studies and improved external field corrections for core and crustal studies. [ABSTRACT FROM AUTHOR]

The International Geomagnetic Reference Field (IGRF) is a set of parameters representing the large-scale internal part of Earth's magnetic field. The 13th generation IGRF requested candidate models for a definitive main field for 2015.0, a provisional main field for 2020.0, and a predictive secular variation covering the period 2020.0–2025.0. The University of Colorado (CU) and the National Centers for Environmental Information (NCEI), part of the National Oceanic and Atmospheric Administration (NOAA), have produced these three candidate models for consideration in IGRF-13. In this paper, we present the methodology used to derive our candidate models. Our candidates were built primarily from Swarm satellite data, and also relied on geomagnetic indices derived from the ground observatory network. The ground observatories played a crucial role as independent data in validating our candidates. This paper also provides a retrospective assessment of the CU/NCEI candidate model to the previous IGRF (IGRF-12) and discusses the impact of differences between candidate and final IGRF models on global model errors. [ABSTRACT FROM AUTHOR]

In December 2019, the 13th revision of the International Geomagnetic Reference Field (IGRF) was released by the International Association of Geomagnetism and Aeronomy (IAGA) Division V Working Group V-MOD. This revision comprises two new spherical harmonic main field models for epochs 2015.0 (DGRF-2015) and 2020.0 (IGRF-2020) and a model of the predicted secular variation for the interval 2020.0 to 2025.0 (SV-2020-2025). The models were produced from candidates submitted by fifteen international teams. These teams were led by the British Geological Survey (UK), China Earthquake Administration (China), Universidad Complutense de Madrid (Spain), University of Colorado Boulder (USA), Technical University of Denmark (Denmark), GFZ German Research Centre for Geosciences (Germany), Institut de physique du globe de Paris (France), Institut des Sciences de la Terre (France), Pushkov Institute of Terrestrial Magnetism, Ionosphere and Radio Wave Propagation (Russia), Kyoto University (Japan), University of Leeds (UK), Max Planck Institute for Solar System Research (Germany), NASA Goddard Space Flight Center (USA), University of Potsdam (Germany), and Université de Strasbourg (France). The candidate models were evaluated individually and compared to all other candidates as well to the mean, median and a robust Huber-weighted model of all candidates. These analyses were used to identify, for example, the variation between the Gauss coefficients or the geographical regions where the candidate models strongly differed. The majority of candidates were sufficiently close that the differences can be explained primarily by individual modeling methodologies and data selection strategies. None of the candidates were so different as to warrant their exclusion from the final IGRF-13. The IAGA V-MOD task force thus voted for two approaches: the median of the Gauss coefficients of the candidates for the DGRF-2015 and IGRF-2020 models and the robust Huber-weighted model for the predictive SV-2020-2025. In this paper, we document the evaluation of the candidate models and provide details of the approach used to derive the final IGRF-13 products. We also perform a retrospective analysis of the IGRF-12 SV candidates over their performance period (2015–2020). Our findings suggest that forecasting secular variation can benefit from combining physics-based core modeling with satellite observations. [ABSTRACT FROM AUTHOR]

In December 2019, the International Association of Geomagnetism and Aeronomy (IAGA) Division V Working Group (V-MOD) adopted the thirteenth generation of the International Geomagnetic Reference Field (IGRF). This IGRF updates the previous generation with a definitive main field model for epoch 2015.0, a main field model for epoch 2020.0, and a predictive linear secular variation for 2020.0 to 2025.0. This letter provides the equations defining the IGRF, the spherical harmonic coefficients for this thirteenth generation model, maps of magnetic declination, inclination and total field intensity for the epoch 2020.0, and maps of their predicted rate of change for the 2020.0 to 2025.0 time period. [ABSTRACT FROM AUTHOR]

The magnetic equator in the Brazilian region has moved over 1,100 km northward since 1957, passing the geomagnetic observatory Tatuoca (TTB), in northern Brazil, around 2013. We recovered and processed TTB hourly mean values of the geomagnetic field horizontal (H) component from 1957 until 2019, allowing the investigation of long-term changes in the daily variation due to the influence of secular variation, solar activity, season, and lunar phase. The H day-to-day variability and the occurrence of the counter electrojet at TTB were also investigated. Until the 1990s, ionospheric solar quiet currents dominated the quiet-time daily variation at TTB. After 2000, the magnitude of the daily variation became appreciably greater due to the equatorial electrojet (EEJ) contribution. The H seasonal and day-to-day variability increased as the magnetic equator approached, but their amplitudes normalized to the average daily variation remained at similar levels. Meanwhile, the amplitude of the lunar variation, normalized in the same way, increased from 5% to 12%. Within the EEJ region, the occurrence rate of the morning counter electrojet (MCEJ) increased with proximity to the magnetic equator, while the afternoon counter electrojet (ACEJ) did not. EEJ currents derived from CHAMP and Swarm satellite data revealed that the MCEJ rate varies with magnetic latitude within the EEJ region while the ACEJ rate is largely constant. Simulations with the Thermosphere-Ionosphere-Electrodynamics General Circulation Model based on different geomagnetic main field configurations suggest that long-term changes in the geomagnetic daily variation at TTB can be attributed to the main field secular variation. [ABSTRACT FROM AUTHOR]

Abstract: We use a set of ground‐based instruments (Global Positioning System receivers, ionosondes, magnetometers) along with data of multiple satellite missions (Swarm, C/NOFS, DMSP, GUVI) to analyze the equatorial and low‐latitude electrodynamic and ionospheric disturbances caused by the geomagnetic storm of 22–23 June 2015, which is the second largest storm in the current solar cycle. Our results show that at the beginning of the storm, the equatorial electrojet (EEJ) and the equatorial zonal electric fields were largely impacted by the prompt penetration electric fields (PPEF). The PPEF were first directed eastward and caused significant ionospheric uplift and positive ionospheric storm on the dayside, and downward drift on the nightside. Furthermore, about 45 min after the storm commencement, the interplanetary magnetic field (IMF) Bz component turned northward, leading to the EEJ changing sign to westward, and to overall decrease of the vertical total electron content (VTEC) and electron density on the dayside. At the end of the main phase of the storm, and with the second long‐term IMF Bz southward turn, we observed several oscillations of the EEJ, which led us to conclude that at this stage of the storm, the disturbance dynamo effect was already in effect, competing with the PPEF and reducing it. Our analysis showed no significant upward or downward plasma motion during this period of time; however, the electron density and the VTEC drastically increased on the dayside (over the Asian region). We show that this second positive storm was largely influenced by the disturbed thermospheric conditions. [ABSTRACT FROM AUTHOR]

The ionospheric gravity and pressure-gradient current systems are most prominent in the low-latitude $F$ -region due to the plasma density enhancement known as the equatorial ionization anomaly (EIA). This enhancement of plasma density which builds up during the day and lasts well into the evening supports a toroidal gravity current which flows eastward around the Earth in the $F$ -region during the daytime and evening, and eventually returns westward through the $E$ -region. The existence of pressure-gradients in the EIA region also gives rise to a poloidal diamagnetic current system, whose flow direction acts to reduce the ambient geomagnetic field inside the plasma. The gravity and pressure-gradient currents are among the weaker ionospheric sources, with current densities of a few $\mbox{nA/m}^{2}$ , however they produce clear signatures of about 5-7 nT in magnetic measurements made by low-Earth orbiting satellites. In this work, we review relevant observational and modeling studies of these two current systems and present new results from a 3D ionospheric electrodynamics model which allows us to visualize the entire flow pattern of these currents throughout the ionosphere as well as calculate their magnetic perturbations. [ABSTRACT FROM AUTHOR]

The attraction to study medicine has not changed, however we are facing a lack of trainees especially in surgical subspecialties like urology. Possible explanations are a 70% proportion of female students and different views on the work-life balance in the future. A high burden of theory and unrealistic multiple choice examinations support those who can learn but there are no objective and reproducible criteria to recognize the competence of a good physician early in the career. This problem continues during residency, especially in surgical subspecialities. The different medical boards in Germany responsible for the training programs have no concepts. Many attempts in other countries to objectively measure surgical skills have so far been ignored. If we do not want to lose our traditionally high competence in medicine we should join those who attempt to improve teaching and to use methods for selecting suitable candidates for surgery as soon and as objectively as possible. [ABSTRACT FROM AUTHOR]

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Introduction: The pathogenesis of calcium oxalate stone formation is not completely understood. Recently, an influence of vascular phenomena like arteriosclerosis on the crystallization process was hypothesized. Thus, stone formation should be more common in patients with diabetes mellitus (DM) who are at risk of developing angiopathy. The aim of the study was to determine the prevalence of urolithiasis (UL) in patients with DM and to identify specific risk factors. Material and Methods: 350 patients with DM were evaluated with respect to DM-related history, and a total of 179 patients was included (83 female, 96 male; age 23–84 years). All patients were interviewed to assess the history of stone formation. These data were compared to epidemiological data in Germany. Results: The overall prevalence of UL in the diabetic group was 7.82% (vs. 4.73% in Germany, p = 0.0485; binominal test). The prevalence was significantly higher in patients with coronary heart disease (25%; p < 0.0001; Fisher‘s exact test). We could not demonstrate an increased prevalence of UL for patients with occlusive arterial disease or arterial hypertension as diabetic nephropathy was not a risk factor for developing urinary lithiasis (p = 0.7184, p = 1.000, p = 0.6266, respectively; Fisher’s exact test). Thiazide medication lowered the prevalence of stone formation (p = 0.0399; Fisher’s test). Calcium or magnesium supplementation did not influence stone formation significantly (p = 0.5279; p = 1.000; respectively; Fisher’s test). Conclusions: In Germany, patients with DM are at higher risk of UL compared with patients without diabetes. We demonstrated a significantly higher prevalence of urinary stones in patients with coronary heart disease. These findings are consistent with the hypothesis that urinary stone formation has a vascular pathogenesis in part. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to evaluate the influence of propiverine-HCl (P4) and propiverine-N-oxide (P4NO), one of the major metabolites of P4, on bladder contraction in a standardized in vivo model. Additionally, salivary flow measurements enabled the evaluation of hyposalivation, one of the most predominant anticholinergic side effects. Materials and Methods: Ten male mini pigs were anesthetized. P4 (0.4 mg/kg b.w.) and P4NO (0.422 mg/kg b.w.) were administered intravenously. Bladder contractions were induced through sacral anterior root stimulation and cystometrogram evaluation was performed. For stimulation-induced salivary flow measurements, the lingual nerve was exposed for neurostimulation. The effects of P4 and P4NO on stimulation-induced bladder contraction and salivation were evaluated in 5 mini pigs, respectively. Results: In all experiments, for each animal reproducible intravesical pressure values (Pves) were elicited during sacral anterior root stimulation before administration of the study drug. After administration of P4, Pves decreased by 64% whereas P4NO decreased Pves by 28%. Inhibition of salivary flow with P4 and P4NO was 71 and 32%, respectively. Directly following intravenous administration of P4, a short-term and reversible period of mild fluctuations in heart rate was observed. Administration of P4NO revealed no changes in either heart rate, or blood pressure. Conclusion: All of the investigated parameters revealed less anticholinergic effects for P4NO compared to P4. Under the experimental conditions described above, it may be assumed that P4NO behaves as a substance with poor anticholinergic effects with respect to side effects. As expected, P4 showed anticholinergic effects on bladder contraction and salivation. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Brachytherapy (BT) is an established treatment option for low risk prostate cancer. The aim of this study was to determine the long-term complications and side effects of the procedure in an up to 13 year long single center follow-up analysis.Material: A total of 505 patients were treated by BT for prostate cancer between May 1991 and August 2005. Cohort I (n=412; May 1991 to November 2003) was evaluated by written questionnaire (modified ICS male) and patient chart evaluation in terms of side effects and secondary interventions. In cohort II (n=148; January 2002 to August 2005) perioperative complications were investigated.Results: The mean follow-up was 5.5 years. Perioperative complications were present in 5.4% of patients. Transurethral resection of the prostate was a common secondary intervention, performed in 7% of cases. The rate of incontinence was 6.3% in the long-term follow-up, the rate of potency was 43.5% in those patients who were potent before BT and no hormonal manipulation was performed at any time.Conclusion: BT is a minimally invasive procedure for the treatment of localised "low risk" prostate cancer. Perioperative complications are rare, secondary intervention may be necessary and the patient has to be informed of possible impotence, incontinence and lack of ejaculation. [ABSTRACT FROM AUTHOR]

Aims: Lectins, and especially galectins, appear to be important in malignancy-associated processes. The aim was to analyse comprehensively the presence of galectins in urothelial tumours. Methods and results: Non-cross-reactive antibodies against seven family members from the three subgroups (prototype: galectin-1, -2 and -7; chimera type: galectin-3; tandem-repeat type: galectin-4, -8 and -9) were used. Gene expression was monitored in specimens of normal urothelium, fresh tumour tissue and cell lines by real-time polymerase chain reaction (PCR). The presence and evidence of tumour-associated up-regulation were shown for galectin-1 and -3. This was less clear-cut for galectin-4 and -8. Galectin-7 was expressed in all cell lines; galectin-2 and -9 were detected at comparatively low levels. Galectin-2, -3 and -8 up-regulation was observed in superficial tumours, but not in muscle-invasive tumours ( P < 0.05). Immunoreactivity correlated with tumour grading for galectin-1, -2 and -8, and disease-dependent mortality correlated with galectin-2 and -8 expression. Binding sites were visualized using labelled galectins. Conclusions: The results demonstrate a complex expression pattern of the galectin network in urothelial carcinomas. Galectin-1, -2, -3 and -8 are both potential disease markers and also possible targets for bladder cancer therapy. [ABSTRACT FROM AUTHOR]

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The first successful nephropexy was performed in the year 1881. From this time, surgical therapy of nephroptosis has always been a subject of discussion. A partly uncritical acceptance led to nephropexy being the most performed urological operation at the beginning of the 20th century, with up to 200 different surgical variations. As early as the 15th century, a first description of ren mobilis was made by Alessius de Pedemontanus. The first surgical intervention for the treatment of nephroptosis was performed by Gilmore in 1870. In 1877, the American Dowell from New Orleans tried a fixation of the kidney through a seton, however, this operation failed. Eventually in 1881, Eugen Hahn from Berlin was able to perform the first successful nephropexy, he named this method "nephroraphy". In 1882, the first modification was made by Bassini with sutures through the renal capsule. Finally, the gynaecologist George Edebohl led nephropexy into a great popularity and secured the method through numerous technical innovations. By 1936, approximately 170 different surgical methods existed for fixation of the kidney. An accurate diagnosis is imperative before performing nephropexy. There were times in which this operation was carried out much too often and, therefore, had a bad reputation. However, it is not correct to drop nephropexy altogether as some would prefer. The statement by Professor Voelcker from Halle in the year 1911 that for all those who have a urinary obstruction and those with a beginning dilation, nephropexy is still justified and may - when correctly performed provide many blessings". Nothing needs to be added to this. [ABSTRACT FROM AUTHOR]

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On 23 September 1901, Georg Kelling (1866-1945) from Dresden performed a celioscopy with a Nitze cystoscope on a dog in Hamburg. This was the beginning of the era of laparoscopy.His doctoral thesis already reflected his early interest in the anatomy and physiology of the gastrointestinal tract. This experience, together with his knowledge on air insufflation of the abdomen, enabled him to be the first to develop the procedure he named "celioscopy." During this pioneer time of laparoscopy, he developed various basic principles that are still valid today and demonstrated astonishingly visionary skills. Although his pioneering achievements have hardly been acknowledged to this day, modern laparoscopy has confirmed Kelling's visions and scientific work in almost all aspects. His name and achievements have most definitely earned a place in the history of endoscopy. [ABSTRACT FROM AUTHOR]

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Objective: To investigate whether the differentiated resection technique for excising superficial bladder cancer leads to higher recurrence and progression rates as compared with regular resection. Subjects and Methods: We evaluated 163 patients, 66 undergoing a differentiated and 97 a regular resection. All patients underwent a routine second resection within 6–10 weeks. Recurrence and progression rates as well as tumour persistence on second resection were analyzed. Results: Patients with differentiated resections of bladder tumours did not have higher tumour recurrence and progression rates. Also, these patients had a significantly higher percentage of tumour-free second resections (p = 0.03). Conclusion: The differentiated resection technique for excising superficial bladder cancer has no negative influence on recurrence and progression rates, but it leads to a reduced tumour persistence. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The death of Wolfgang Amadeus Mozart was mysterious from the very first day, and cause of wildest speculation and adventurous assertions. Over the last 100 years, medical science has investigated the physical sufferings and the mysterious death of Mozart with increasing intensity. By means of letters from his father Leopold, his sister "Nannerl", himself and reports from his physicians and contemporaries, we would like to create a medical pathography. The rumour that Mozart was poisoned appeared soon after his early death at the age of 35 on December 5th 1791, and was kept up persistently. Accused were the physician van Swieten, Mozart's freemason's loge and the royal band master Salieri. Mozart, however, died due to chronic kidney disease and ultimately due to uraemia. Once the renal damage has reached a certain point, a minimum of additional stress leads to decompensation. This catastrophe occurs typically within the fourth decade of life. When listening to Mozart's music, we should remember that this apparently happy person was actually a premature adult robbed of his childhood, whose short life was an endless chain of indisposition, over fatigue, misery, concern and illness. [ABSTRACT FROM AUTHOR]

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Tumours ferment glucose to lactate even in the presence of oxygen (aerobic glycolysis; Warburg effect). The pentose phosphate pathway (PPP) allows glucose conversion to ribose for nucleic acid synthesis and glucose degradation to lactate. The nonoxidative part of the PPP is controlled by transketolase enzyme reactions. We have detected upregulation of a mutated transketolase transcript (TKTL1) in human malignancies, whereas transketolase (TKT) and transketolase-like-2 (TKTL2) transcripts were not upregulated. Strong TKTL1 protein expression was correlated to invasive colon and urothelial tumours and to poor patients outcome. TKTL1 encodes a transketolase with unusual enzymatic properties, which are likely to be caused by the internal deletion of conserved residues. We propose that TKTL1 upregulation in tumours leads to enhanced, oxygen-independent glucose usage and a lactate-based matrix degradation. As inhibition of transketolase enzyme reactions suppresses tumour growth and metastasis, TKTL1 could be the relevant target for novel anti-transketolase cancer therapies. We suggest an individualised cancer therapy based on the determination of metabolic changes in tumours that might enable the targeted inhibition of invasion and metastasis.British Journal of Cancer (2006) 94, 578–585. doi:10.1038/sj.bjc.6602962 www.bjcancer.com Published online 7 February 2006 [ABSTRACT FROM AUTHOR]

The introduction of percutaneous nephrolithotomy (PNL) marked a turning point in the interventional treatment of nephrolithiasis. For the first time, the minimally invasive removal of larger kidney stones, which had previously required open surgery, became possible. With the increasing use of extracorporeal shock wave lithotripsy (SWL) during the 1980s, PNL lost clinical importance. However, since SWL has revealed its limitations, and both the patients' wishes and economic demand require a fast stone removal, the importance of PNL has risen again. Given the correct indications and performance, PNL is an efficient treatment modality reaching stone free rates of up to 100%. When PNL is performed by an experienced urologist, complications are low and can be managed conservatively in most cases. The most important step in the performance of a PNL is the anatomically correct puncture of the kidney gaining optimal access to the stone. To reach this, a lower calyx is punctured whenever possible, under combined sonographic and fluoroscopic guidance. [ABSTRACT FROM AUTHOR]

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The high recurrence rate in superficial bladder cancer (>70%) is caused by the adhesion of free floating tumor cells during transurethral treatment, by incomplete resections, and by overlooked and new tumors. Frequent follow-ups and reoperations are necessary. A single immediate instillation after TUR shows positive effects in reducing recurrence rates and is therefore recommended in the European Guidelines from 2001. The amount, concentration, instillation time, and substances have not yet been standardized. By analyzing the literature we found many different techniques of early instillation therapy. Different substances, concentrations, varying instillation times, and application times make a comparison of these studies very difficult. Further studies are needed to standardize early postoperative instillation therapy. [ABSTRACT FROM AUTHOR]

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In children, abnormal behavior during micturition, i.e. detrusor/sphincter dyscoordination, causes persistent voiding problems, urinary incontinence and/or recurrent urinary tract infections in up to 15% of cases. Contractions of the external urethral sphincter during micturition lead to functional subvesical obstruction. Nowadays, biofeedback training is the most suitable therapy. Biofeedback training for children is based on the assumption that relaxation and contraction of the urinary external sphincter is a habitual phenomenon and can be restored. With specially developed, computer-assisted biofeedback programs, sphincter contraction and relaxation can be transformed into acoustic or visual signals. Acoustic or optical feedback indicates relaxation and contraction control to the patient. The residual urine volume should subsequently be assessed. The results should be reviewed after each micturition. Poor compliance sometimes makes biofeedback training impossible. Further biofeedback training at home is a reasonable suggestion. Good results-a response rate of up to 90%-demonstrates that biofeedback training is successful in the treatment of detrusor-sphincter dyscoordination. After effective therapy, associated urinary tract infections and vesicoureterorenal reflux may disappear. [ABSTRACT FROM AUTHOR]