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Polyarteritis nodosa (PAN) presents mostly as a systemic disease with poor prognosis, rarely in an isolated form with a usually favorable outcome. Both forms may affect the male reproductive system and both forms have been associated with malignancies. We describe for the first time the occurrence of isolated PAN in the reproductive system combined with a mixed germ cell tumor of the testis in a 21-year-old man presenting with symptoms of chronic epididymitis. Two years after surgery he is without evidence of recurrence of either the tumor or PAN.

We are developing metallic magnetic calorimeters (MMC) to improve accuracy on nuclear and atomic data determination such as electron capture probabilities and beta spectrum shape factors. We describe the concept and realization of MMC enclosing radioactive sources (55Fe, 36Cl) in a 4π geometry allowing for unprecedented detection efficiency for both electrons and X-rays throughout an energy range of more than two-orders of magnitude. First results of detector characterization are presented.

The Thorium-229 isotope features a nuclear isomer state with an extremely low energy. The currently most accepted energy value, 7.8 +- 0.5 eV, was obtained from an indirect measurement using a NASA x-ray microcalorimeter with an instrumental resolution 26 eV. We study, how state-of-the-art magnetic metallic microcalorimeters with an energy resolution down to a few eV can be used to measure the isomer energy. In particular, resolving the 29.18 keV doublet in the \gamma-spectrum following the \alpha-decay of Uranium-233, corresponding to the decay into the ground and isomer state, allows to measure the isomer transition energy without additional theoretical input parameters, and increase the energy accuracy. We study the possibility of resolving the 29.18 keV line as a doublet and the dependence of the attainable precision of the energy measurement on the signal and background count rates and the instrumental resolution., Comment: 32 pages, 8 figures, eq. (3) corrected

The properties of amorphous solids below 1 K are dominated by atomic tunneling systems. A basic description is given by the standard tunneling model. Despite its success, the standard tunneling model still remains phenomenological and little is known about the microscopic nature of tunneling systems in amorphous solids. We present dielectric polarization echo experiments on partially deuterated amorphous glycerol. Nuclear quadrupoles, introduced by the deuteration, influence the echo amplitude in a characteristic way and allow us to draw for the first time detailed conclusions about the microscopic nature of the tunneling processes in amorphous glycerol.

We report on a feasibility study on precise determination of mass-specific activity of low-energy emitting radioisotopes. Conventional methods of activity measurement suffer from source self-absorption and a strong decrease in detection efficiency for low-energy electrons and photons. We propose a new method based on metallic magnetic microcalorimeters with the source embedded in the detector target in a 4 π geometry. First results with a 55 Fe source show that electrons and photons are detected with a detection efficiency close to unity and with little loss of energy for electrons. The aim of this study is to provide standards of activity with very low uncertainties in the framework of radiation metrology.

We describe a prototype γ-ray detector based on a metallic magnetic calorimeter with an energy resolution of 46 eV at 60 keV and a reproducible response function that follows a simple second-order polynomial. The simple detector calibration allows adding high-resolution spectra from different pixels and different cool-downs without loss in energy resolution to determine γ-ray centroids with high accuracy. As an example of an application in nuclear safeguards enabled by such a γ-ray detector, we discuss the non-destructive assay of 242Pu in a mixed-isotope Pu sample.

For the first time we have investigated the behavior of fully micro-fabricated low temperature metallic magnetic calorimeters (MMCs) after undergoing an ion-implantation process. This experiment had the aim to show the possibility to perform a high precision calorimetric measurement of the energy spectrum following the electron capture of $^{163}$Ho using MMCs having the radioactive $^{163}$Ho ions implanted in the absorber. The implantation of $^{163}$Ho ions was performed at ISOLDE-CERN. The performance of a detector that underwent an ion-implantation process is compared to the one of a detector without implanted ions. The results show that the implantation dose of ions used in this experiment does not compromise the properties of the detector. In addition an optimized detector design for future $^{163}$Ho experiments is presented. For the first time we have investigated the behavior of fully micro-fabricated low temperature metallic magnetic calorimeters (MMCs) after undergoing an ion-implantation process. This experiment had the aim to show the possibility to perform a high precision calorimetric measurement of the energy spectrum following the electron capture of 163 Ho using MMCs having the radioactive 163 Ho ions implanted in the absorber. The isotope 163 Ho decays through electron capture to 163 Dy and features the smallest known For the first time we have investigated the behavior of fully micro-fabricated low temperature metallic magnetic calorimeters (MMCs) after undergoing an ion-implantation process. This experiment had the aim to show the possibility to perform a high precision calorimetric measurement of the energy spectrum following the electron capture of $^{163}$Ho using MMCs having the radioactive $^{163}$Ho ions implanted in the absorber. The implantation of $^{163}$Ho ions was performed at ISOLDE-CERN. The performance of a detector that underwent an ion-implantation process is compared to the one of a detector without implanted ions. The results show that the implantation dose of ions used in this experiment does not compromise the properties of the detector. In addition an optimized detector design for future $^{163}$Ho experiments is presented.

Vibrating reed measurements are a common technique to investigate the low-frequency elastic properties of disordered solids. To enhance the sensitivity we have set up a new inductive detection technique using a commercial DC-SQUID. We have investigated the elastic properties of a-SiO2 by simultaneously using the SQUID detection and the conventional capacitive detection method. The inductive technique was convincing and showed a much better signal-to-noise ratio than the capacitive method.

The descriptive term hybrid peripheral nerve sheath tumor refers to any neoplasm of the neurilemmal apparatus composed of more than one pathologically defined tumoral equivalent derived from its constituent cells. Within this uncommon nosological category, participation of granular cell tumor - a neoplasm of modified Schwann cells - has been reported only exceptionally. We describe a hitherto not documented variant composed of an organoid mixture of granular cell tumor and perineurioma with plexiform growth. A solitary subcutaneous nodule of 1.5 cm diameter was excised from the right ring finger of a 19-year-old female with no antecedents of neurofibromatosis or relevant trauma. Histology revealed a monotonous, yet cytologically dimorphic proliferation of classical granular cells intermingled with flattened, inconspicuous perineurial cells. Immunohistochemical double labeling detected expression of S100 protein in the former and of EMA and GLUT-1 in the latter. While the respective staining patterns for S100 protein and EMA or GLUT-1 tended to be mutually exclusive, a minority of cells exhibited transitional granular cell/perineurial immunophenotype. Electron microscopy permitted direct visualization of a plethora of lysosomes in the granular cell moiety, and of pinocytotic vesicles and tight junctions in perineurial cells. Intratumoral axons were not detected. Expanding intraneurally, the lesion showed discrete encapsulation by the local perineurium, and resulted in plexiform growth. The MIB-1 labeling index averaged 1%. We interpret our findings as supporting evidence for the dual cell lineage to have arisen through metaplasia, with the tumor's dynamics probably having been driven by the granular cell component.

To test the prognostic significance of cyclin D1 in nodal-positive prostate cancer.Nuclear and cytoplasmic cyclin D1 expression was evaluated in 119 nodal-positive prostate cancer patients undergoing radical prostatectomy and extended lymphadenectomy. Cyclin D1 was correlated with various tumour features and biochemical recurrence-free survival (bRFS), disease-specific survival (DSS) and overall survival (OS). In the metastases, high-level cytoplasmic cyclin D1 expression independently predicted poor outcome (5-year bRFS, 12.5% versus 26.4%, P = 0.006; 5-year DSS, 56.3% versus 80.7%, P = 0.007; 5-year OS, 56.3% versus 78.7%, P = 0.011). These patients had a 2.62-fold elevated risk of dying from prostate cancer as compared with patients with low-level cytoplasmic cyclin D1 expression (P = 0.024). All other subcellular compartments of cyclin D1 expression in primary tumours and metastases were prognostically non-significant.The subcellular location of cyclin D1 expression in prostate cancer is linked to specific clinical courses. Survival stratification according to biomarker expression in metastases indicates an important role for tumour sampling from these tissues.

To evaluate risk factors in lymph node-positive bladder cancer.Lymph node-positive bladder cancer patients (n=162), preoperatively staged N0M0, underwent cystectomy and standardized extended lymphadenectomy. Five-year overall survival of the cohort was 33%. In univariate analysis, tumour stage (P0.006), extracapsular extension of lymph node metastases (P0.001), total diameter of metastases (P0.04) and lymph node stage (P0.03) were significantly correlated with overall survival (OS), disease-specific survival (DSS) and recurrence-free survival (RFS). On multivariate analysis, only extracapsular extension (OS, P0.002; DSS, P0.02; RFS, P=0.058) and primary tumour stage (OS, P=0.058; DSS, P0.02; RFS, P0.02) added independent prognostic information. Extracapsular extension of lymph node metastases did not correlate with a specific recurrence pattern; patients with organ-confined tumours (pT1/2) never had pelvic relapse.Extracapsular extension of lymph node metastases but not lymph node tumour burden adds independent prognostic information in lymph node-positive bladder cancer. These biological differences in lymph node-positive bladder cancer are not reflected in the sixth, and challenge future, TNM classification.

Background Her2, an alias for the protein of v-erb-b2 erythroblastic leukemia viral oncogene homolog 2, neuro/glioblastoma derived oncogene homolog (avian), might be an attractive therapeutic target in metastasising bladder cancer. Genotype and phenotype of primary tumours and their metastases may differ. Objectives Determine Her2 status in both tumour components to better assess the potential of anti-Her2 therapies. Design, setting, and participants Histologic examination revealed lymph node metastases in 150 patients with urothelial bladder cancer clinically staged as N0M0. A tissue microarray was constructed with four tumour samples per patient: two from the primary tumour and two from nodal metastases. Her2 status was determined at the gene level by fluorescence in situ hybridisation (FISH) and at the protein level by immunohistochemistry (IHC). Interventions All patients underwent cystectomy and standardised extended lymphadenectomy. Measurements Overall survival was assessed according to HER2 gene status and protein expression in primary bladder cancers and lymph node metastases. Results and limitations Her2 amplification was significantly more frequent in lymph node metastases (15.3%) than in matched primary bladder cancers (8.7%; p =0.003). Her2 amplification in primary tumours was highly preserved in the corresponding metastases as indicated by only one amplified primary tumour without amplification of the metastasis. There was a high concordance in HER2 FISH results between both samples from the primary tumour (κ=0.853) and from the metastases (κ=0.930). IHC results were less concordant (κ=0.539 and 0.830). FISH and IHC results were poorly correlated in primary tumours (κ=0.566) and metastases (κ=0.673). While Her2 amplification in the primary tumour significantly predicted poor outcome ( p =0.044), IHC-based survival prediction was unsuccessful. Conclusions Her2 amplification in metastasising bladder cancer is relatively frequent, is homogeneous in each tumour component, and predicts early death. This suggests a high potential for anti-Her2 therapies. For patient selection, FISH might be more accurate than IHC.

CD10 predicts survival in different cancers. The prognostic significance in bladder cancer still has to be documented. One hundred fifty lymph node-positive bladder cancer patients were treated by cystectomy and standardized pelvic lymphadenectomy in curative intent. CD10 expression was evaluated in tissue microarrays (TMAs) constructed from histopathological normal urothelium, primary tumor (tumor center and invasion front), and corresponding lymph node metastases and correlated with tumor characteristics (stage, extracapsular extension, number, and total diameter of metastases) and survival. CD10 expression was successively lost from normal urothelium to primary tumor to metastases (P < .05) and decreased from the tumor center to the invasion front (P < .002). High CD10 expression in tumor center or invasion front (P < .05) but not in the metastases predicted favorable outcome; the prognostic information in the tumor center was independent from tumor stage and lymph node parameters. High CD10 expression level was not associated with specific tumor characteristics. A well-defined sampling strategy for TMAs allows detection of specific biomarker expression patterns and may generate prognostic information inherent in particular tumor areas. The favorable outcome in bladder cancer patients with high CD10 expression might suggest a tumor suppressive function of CD10.

Androgen receptor (AR) expression profile in the different Gleason patterns (GP) of primary prostate cancers and nodal metastases is unknown. More information about AR distribution is needed to optimize evaluation methods and to better understand the role of AR in development and progression of prostate cancer.A tissue microarray was constructed from 119 hormone-naïve nodal positive, surgically treated prostate cancers containing tissues from all GP present in every primary tumor and the matched metastases. ARs were evaluated immunohistochemically and an expression score (intensity × percentage of positive cells) was assigned for each tissue spot.ARs were up-regulated in primary tumors compared to normal glands and significantly different expressed in the GP (mean AR scores: GP 3=128.7, GP 4=159.1, GP 5=123.5; P=0.016). A similar expression profile was observed in metastases, however, on significantly (P0.001) lower level (mean AR scores: GP 3=70.5, GP 4=90.4, GP 5=71.7; P=0.114). High AR expression in metastases was associated with larger total size of metastases (P=0.008). All other correlations of AR expression in primary tumors and metastases with quantitative (age, prostate cancer volume, number of metastases) or categorical (tumor stage, Gleason score of the primary tumor and metastases) tumor characteristics or with survival were insignificant.ARs are differentially expressed in GP what should be considered in prognostic models which include AR. In nodal metastases, ARs are significantly down-regulated suggesting decreased dependence on androgens already under hormone-naïve conditions. AR expression level is not prognostic in nodal positive disease.

Using a magnetic calorimeter, we have obtained an energy resolution of 13 eV in the detection of 6 keV X-rays. The calorimeter consisted of a 50 μm diameter, 25 μm thick Au sensor doped with 300 ppm Er. A 100×100 μm square, 8 μm thick Au absorber was attached to the sensor. At the operating temperature of 33 mK and with a field of 3 mT, the calorimeter had a heat capacity of 1.3×10 −12 J / K . With a magnetic calorimeter optimized for X-ray detection an order of magnitude improvement in resolution should be possible.

A 52-yr-old man presented with hematuria and clot retention. He had undergone simultaneous pancreas-kidney transplantation with exocrine pancreas bladder drainage 16 yr ago. The patient suffered from progressive transplant kidney failure with gradually decreasing urine output and needed hemodialysis every other day. Gross hematuria persisted after removal of all blood clots. Cystoscopy showed multiple small, flat ulcers of the bladder mucosa. Some bled discretely and were coagulated cautiously. However, hematuria was refractory to multiple urological interventions, which eventually necessitated an enteric diversion of the exocrine pancreas. Hematuria ceased following an uneventful postoperative course.

Magnetic microcalorimeters have been developed to detect X-rays with energies up to 100 keV. The magnetization of localized paramagnetic ions embedded in a metal is measured with a SQUID and is used to determine very small temperature changes resulting from the absorption of energy. The response of such detectors can be calculated from equilibrium statistical thermodynamics. Our present best result of 90 eV resolution at 6 keV has been obtained with a calorimeter of 600 ppm Er 3+ in Au at 55 mK, at which temperature the detector had a heat capacity of 3×10 −12 J/K. Upon optimization of the parameters of the calorimeter a resolution of less than 2 eV is predicted to be achievable at 50 mK and less than 1 eV at lower temperatures. The coupling of the conduction electrons to the ions leads to very fast thermalization times even at low temperatures.

BACKGROUND: Conflicting results exist regarding the value of an extended pelvic lymph node dissection (PLND) in node-positive patients undergoing radical retropubic prostatectomy (RRP) for clinically localized prostate cancer. OBJECTIVE: To assess the long-term outcome in node-positive patients who underwent extended PLND followed by RRP. DESIGN, SETTING, AND PARTICIPANTS: A consecutive series of 122 node positive patients with negative preoperative staging examinations, no neoadjuvant hormonal or radiotherapy, and who underwent extended PLND (>/=10 lymph nodes in the surgical specimen) followed by RRP were analyzed. None of the patients received immediate androgen deprivation therapy (ADT). INTERVENTION: All patients underwent extended PLND followed by RRP. MEASUREMENTS: Biochemical recurrence-free survival, cancer-specific, and overall survival were assessed using the Kaplan-Meier technique. RESULTS AND LIMITATIONS: Median prostate-specific antigen (PSA) was 16ng/ml. At pathological examination 76% of the 122 patients had pT3-pT4 tumours, 50% seminal vesicle infiltration. A median of 22 nodes were removed per patient. Median cancer-specific survival at 5 and 10 yr was 84.5% and 60.1%, respectively. In patients with /=3 positive nodes removed, median cancer-specific survival at 10 yr was 78.6% and 33.4%, respectively (p/=3 positive nodes removed. This retrospective study includes a significant percentage of patients with high tumour burden, and therefore may not reflect current patient series. CONCLUSIONS: Patients with /=3 positive nodes, despite extended PLND and despite ADT in 69% of patients.

We describe and discuss the features of MARE, an experiment based on arrays of rhenium low temperature microcalorimeters that have the potential to bring the sensitivity to the neutrino mass down to 0.2 eV, by studying the beta spectrum of Re 187 ( Q -value = 2.47 keV).

Metallic magnetic calorimeters are energy dispersive particle detectors that are operated at temperatures below . Applied to x-ray spectroscopy they combine the high energy resolution of crystal spectrometers with the large energy bandwidth of semiconductor detectors. After the absorption of a photon its energy is converted into heat. A paramagnetic alloy converts the temperature change into a change of magnetization that is read out by a sensitive superconducting quantum interference device magnetometer. With such a metallic magnetic calorimeter we performed two successful measurements at the internal gas target of the experimental storage ring at GSI. In the first beamtime lithium-like Au-ions were targeted on a N2 and a Xe gas target, respectively. In the second beamtime we observed a projectile beam of bare Xe ions interacting with a Xe gas target. In both experiments we achieved an energy resolution below from to . We were able to detect K-lines of Xe ions of different charge states, including the Lyman series up to Ly-η and could resolve the Ly-β-doublet in H-like Xe.

We demonstrate the capability of micro-calorimeters to detect and mass-resolve neutral atoms and molecules at ~ keV energies, reaching single H-atom resolution.

In this paper we analyze the influence of the coupled energy sensitivity of a superconducting quantum interference device (SQUID) on the energy resolution of metallic magnetic calorimeters. From this, we derive an upper limit on the readout noise that still allows for the readout of detectors with sub-eV energy resolution. Furthermore, we present two dc-SQUID designs, namely a first-stage SQUID and an N-SQUID series array, that are suited for the readout of high-resolution detectors. We show that fabricated SQUIDs have a noise performance that is competitive to the best state-of-the-art dc-SQUIDs. For the first-stage SQUIDs, we found a correlation between the noise exponent α and the noise prefactor (1 Hz). Using both kind of SQUIDs we have built a two-stage dc-SQUID configuration. We show that this setup allows for the readout of x-ray detectors with a resolving power .

The anomalous magnetic field dependence of the dielectric constant in non‐magnetic glasses at very low temperature is explained in terms of the adiabatic non‐linear dielectric susceptibility and its sensitivity to the nuclear quadrupole interaction. This susceptibility is defined by the adiabatic transitions between wells in tunneling systems (TLS) caused by AC field induced energy‐level crossing. The nuclear quadrupole interaction of tunneling atoms increases the number of levels, thus increasing the transition probability. An external magnetic field breaks the Kramers degeneracy of energy levels, increasing the number of energy levels and consequently the dielectric constant. Our analysis qualitatively agree with recent experimental data.

The universal behaviour of amorphous solids at low temperatures, governed by atomic tunneling systems as described by the standard tunneling model, has long been a generally accepted fact. In the last years, however, measurements of dielectric two-pulse polarization echoes have revealed that nuclear quadrupole moments involved in atomic tunneling systems can cause specific material-dependent effects in magnetic fields. We have performed measurements of the dielectric properties of the two multicomponent glasses N-KZFS11 and HY-1, containing several percent of tantalum oxide and holmium oxide respectively. As 181Ta and 165Ho both carry very large nuclear quadrupole moments, these glasses are ideal candidates to study the influence of nuclear quadrupole moments on the properties of glasses at very low temperatures. Our measurements not only show unique dielectric behaviour in both glasses, but also differ significantly from various predictions of the standard tunneling model.

We evaluated the incidence of pathological findings of the ureter at cystectomy for transitional cell carcinoma of the bladder and assessed the usefulness of intraoperative frozen section examination of the ureter.Histopathological findings of ureteral frozen section examination were compared to the corresponding permanent sections and the diagnostic accuracy of frozen section examination was evaluated. These segments were then compared to the more proximal ureteral segments resected at the level where they cross over the common iliac arteries. The histopathological findings of the ureteral segments were then correlated for upper urinary tract recurrence and overall survival.Transitional cell carcinoma or carcinoma in situ was found on frozen section examination of the distal ureter in 39 of 805 patients (4.8%) and on permanent sections in 29 (3.6%). In 755 patients the false-negative rate of frozen section examination of the ureters was 0.8%. Of the patients with carcinoma in situ diagnosed on the first frozen section examination 80% also had carcinoma in situ in the bladder. Transitional cell carcinoma or carcinoma in situ in the most proximally resected ureteral segments was found in 1.2% of patients. After radical cystectomy there was tumor recurrence in the upper urinary tract in 3% of patients with negative ureteral frozen section examination and in 17% with carcinoma in situ on frozen section examination.Routine frozen section examination of the ureters at radical cystectomy is only recommended for patients with carcinoma in situ of the bladder, provided the ureters are resected where they cross the common iliac arteries.

Neutrino oscillation experiments have proved that neutrinos are massive particles, but can't determine their absolute mass scale. Therefore the neutrino mass is still an open question in elementary particle physics. An international collaboration is growing around the project of Microcalorimeter Arrays for a Rhenium Experiment (MARE) for directly measuring the neutrino mass with a sensitivity of about 0.2eV/c2. Many groups are joining their experiences and technical expertise in a common effort towards this challenging experiment. We discuss the different scenarios and the impact of MARE as a complement of KATRIN., 3 pages, 1 figure Nucl. Instr. Meth. A, proceedings of LTD11 workshop, Tokyo 2005

Controversy persists concerning the role of pelvic lymph node dissection (PLND) in patients with preoperative PSA values10ng/ml undergoing treatment for prostate cancer with a curative intent. The aim of this study was to determine the incidence of lymph node metastasis in this subgroup of patients.Patients with clinically localized prostate cancer and a serum PSA10ng/ml, without neoadjuvant hormonal or radiotherapy, with negative staging examinations who underwent radical retropubic prostatectomy with bilateral extended PLND and with/=10 lymph nodes detected by the pathologist in the surgical specimen, were included in the study.A total of 231 patients with a median serum PSA of 6.7ng/ml (range 0.4-9.98) and a median age of 62 years (range 44-76) were evaluated. A median of 20 (range 10-72) nodes were removed per patient. Positive nodes were found in 26 of 231 patients (11%), the majority of which (81%) had a Gleason score/=7 in the surgical specimen. Of the patients with a Gleason score/=7 in the prostatectomy specimen 25% had positive nodes, whereas only 3% with a Gleason score/=6 were node positive.The incidence of positive nodes in patients with clinically localized prostate cancer, a serum PSA10ng/ml and a Gleason score/=7 in the prostatectomy specimen was 25% after extended PLND. It seems that in this patient group extended PLND, including removal of nodes along the internal iliac vessels, is warranted.

Purpose: We present the long-term results of a large consecutive series of patients undergoing ileal orthotopic bladder substitution following radical cystectomy. Materials and Methods: Between April 1985 and 2005 orthotopic bladder substitution with an ileal low pressure reservoir was performed in 482 patients (including 40 women) after radical and, if possible, nerve sparing cystectomy. In 447 cases the procedure was combined with an afferent ileal isoperistaltic tubular segment. The patients were followed prospectively. Results: In the 482 patients 61 early (less than 30 days) diversion related complications requiring prolonged hospital stay or readmission were noted and 115 late complications required treatment. At 1 year continence was good in 92% of patients during the day and in 79% at night. At last followup 93% of patients could void spontaneously. Of 442 evaluable men 99 (22.4%) reported having erections without and 68 (15.4%) with medical assistance. Ureteroileal stenosis was observed in 12 of 447 (2.7%) patients. Urethral recurrence was detected in 25 of 482 (5%) patients. A total of 15 (5%) patients received vitamin B12 substitution. Renal parenchyma decreased only in patients with preoperative or postoperative ureteral obstruction. After 10 years patients with normal renal function had no long-term acidosis and in 20 patients the incidence of osteoporosis resembled that of the normal population. Conclusions: Ileal orthotopic bladder substitution combined with an afferent ileal tubular segment allows for good long-term functional results provided patients are restrictively selected, postoperative instructions are followed carefully, and typical complications such as outlet obstruction and hernias are treated early.

We prospectively assessed the role of nerve sparing surgery on urinary continence after open radical retropubic prostatectomy.We evaluated a consecutive series of 536 patients who underwent open radical retropubic prostatectomy with attempted bilateral, unilateral or no nerve sparing, as defined by the surgeon, without prior radiotherapy at a minimum followup of 1 year with documented assessment of urinary continence status. Because outlet obstruction may influence continence rates, its incidence and management was also evaluated.One year after surgery 505 of 536 patients (94.2%) were continent, 27 (5%) had grade I stress incontinence and 4 (0.8%) had grade II stress incontinence. Incontinence was found in 1 of 75 (1.3%), 11 of 322 (3.4%) and 19 of 139 patients (13.7%) with attempted bilateral, attempted unilateral and without attempted nerve sparing, respectively. The proportional differences were highly significant, favoring a nerve sparing technique (p0.0001). On multiple logistic regression analysis attempted nerve sparing was the only statistically significant factor influencing urinary continence after open radical retropubic prostatectomy (OR 4.77, 95% CI 2.18 to 10.44, p = 0.0001). Outlet obstruction at the anastomotic site in 33 of the 536 men (6.2%) developed at a median of 8 weeks (IQR 4 to 12) and was managed by dilation or an endoscopic procedure.The incidence of incontinence after open radical retropubic prostatectomy is low and continence is highly associated with a nerve sparing technique. Therefore, nerve sparing should be attempted in all patients if the principles of oncological surgery are not compromised.

Quantitative reverse transcriptase real-time PCR (QRT-PCR) is a robust method to quantitate RNA abundance. The procedure is highly sensitive and reproducible as long as the initial RNA is intact. However, breaks in the RNA due to chemical or enzymatic cleavage may reduce the number of RNA molecules that contain intact amplicons. As a consequence, the number of molecules available for amplification decreases. We determined the relation between RNA fragmentation and threshold values (Ct values) in subsequent QRT-PCR for four genes in an experimental model of intact and partially hydrolyzed RNA derived from a cell line and we describe the relation between RNA integrity, amplicon size and Ct values in this biologically homogenous system. We demonstrate that degradation-related shifts of Ct values can be compensated by calculating delta Ct values between test genes and the mean values of several control genes. These delta Ct values are less sensitive to fragmentation of the RNA and are unaffected by varying amounts of input RNA. The feasibility of the procedure was demonstrated by comparing Ct values from a larger panel of genes in intact and in partially degraded RNA. We compared Ct values from intact RNA derived from well-preserved tumor material and from fragmented RNA derived from formalin-fixed, paraffin-embedded (FFPE) samples of the same tumors. We demonstrate that the relative abundance of gene expression can be based on FFPE material even when the amount of RNA in the sample and the extent of fragmentation are not known.

Context: Bombesin-like neuropeptides including gastrin-releasing peptide (GRP) and their corresponding receptors, mediate multiple physiological actions and have biological significance in cancer. However, information about the function of these neuropeptides and the incidence, distribution, density, and subtype of their receptors in human uterine tissues is scarce. Objective: The objective of the study was to investigate normal and neoplastic human uterine tissues for their bombesin receptor status. Design: In vitro subtype-specific bombesin receptor autoradiography was used in this study. Patients:The following tissue samples were taken immediately after surgery: myometrium (n 41), endometrium (n 29), leiomyomas (n26),leiomyosarcomas(n6),endometrialadenocarcinomas(n 28), and carcinosarcoma (n 1). Results: Normal uterine tissues expressed GRP receptors (GRP-Rs) in the myometrium, in subsets of secretory endometrial glands, and insubsetsofendometrialbloodvesselsofthelateproliferativeandthe secretory phase. Most leiomyomas (20 of 26) expressed GRP-R but not the leiomyosarcomas. GRP-Rs were also detected in 10 of 28 adenocarcinomas, one of one carcinosarcoma, and in blood vessels surrounding the adenocarcinomas. No other bombesin receptor subtypes (neuromedin B receptors and bb3) were detected. Conclusions: These findings may be of physiological and pathophysiological significance. The expression of GRP-R in glands and vessels during specific phases of the cycle suggests a timely precise physiological action of GRP in these targets; in certain uterine neoplasms, the GRP-R overexpression may contribute to tumor development becauseGRPisapotentgrowthfactor.Furthermore,thesefindingsmay be diagnostically and therapeutically relevant. The expression of GRP-R in leiomyomas may allow distinguishing them from receptornegative leiomyosarcomas; GRP-R in leiomyomas, in a subset of endometrial adenocarcinomas, carcinosarcomas, and in peritumoral vessels may be candidates for receptor targeting in vivo. (J Clin Endocrinol Metab 90: 4722–4729, 2005)

Purpose To analyze the prognostic impact of risk factors for urothelial carcinoma of the bladder (UCB) with pelvic lymph node (LN) metastases. Patients and Methods We analyzed a consecutive series of 507 patients with UCB who were preoperatively staged N0M0. One hundred one of 124 eligible patients who were treated with radical cystectomy and standardized extended bilateral pelvic lymphadenectomy with curative intent and had postoperatively confirmed LN metastases were evaluated in regard to recurrence-free and overall survival. Results A median of 22 nodes per patient (range, 10 to 43 nodes) were removed and examined. Median recurrence-free and overall survival durations were 17 months and 21 months (range for both, 1 to 191 months), respectively. In the multivariate analysis for recurrence-free survival, extracapsular extension of LN metastases was the strongest prognostic factor (P = .019). Other variables such as tumor stage (pT1/2 v pT3 and pT4), the number (< five v ≥ five), and the percentage (< 20% v ≥ 20%) of metastatic nodes had a significant influence on recurrence-free and overall survival in the univariate analysis. However, they all failed to be significant prognostic factors in the multivariate analysis. Conclusion The results of this study indicate that radical cystectomy with bilateral lymphadenectomy can have a curative effect in a subset of patients with pelvic LN positive UCB. Provided that a representative number of LNs are removed by meticulous lymphadenectomy and that a thorough histologic examination is performed, prognosis for such patients can be determined quite reliably. In the multivariate analysis, extracapsular extension of LN metastases was the strongest factor predicting prognosis.

In recent years unexpected magnetic field effects have been observed in dielectric measurements on insulating glasses at very low temperatures. Polarization echo experiments have indicated that atomic tunneling systems are responsible for these effects and that the nuclear properties of the tunneling particles are of importance. Subsequently, it was suggested that the magnetic field effects are caused by tunneling systems carrying a nuclear quadrupole moment. Now we have studied the isotope effect in echo experiments on fully deuterated and ordinary glycerol clearly showing the crucial role of the nuclear quadrupole moments for the magnetic field effects. In addition, we have observed a new effect in the decay of spontaneous echoes in zero magnetic field for the deuterated samples which can be explained in terms of a quantum beating involving the quadrupole levels.

Cryogenic detectors offer remarkably better energy resolutions than those achievable with conventional semiconductor or scintillation detectors. With the additional asset of a detection efficiency close to unity for low-energy X-ray photons and electrons, these detectors have the potential to perform X-ray, gamma and electron spectroscopy of a hitherto unknown quality, in particular at low energies. Two types of cryogenic detectors are described and the results of prototype detectors are presented.

Calorimetric particle detectors based on metallic paramagnetic temperature sensors have been shown to be well suited for high resolution particle spectroscopy. Most of the work on metallic magnetic calorimeters has been performed using dilute alloys of erbium in gold as the sensor material. In the temperature range of interest, the thermodynamic properties of erbium ions in gold are well understood. The dependence of the signal size is predictable as a function of temperature, magnetic field and concentration. However, at temperatures below 50 mK the decay of the signal exhibits two relaxation times. Measurements of these time constants and the fractional amplitudes as a function of temperature and field indicate the presence of an additional thermodynamic system within the sensor material. Heat capacity measurements at temperatures as low as 100 μK suggest that this additional contribution arises from the quadrupole splitting of the Au nuclei (l=3/2) in the electric field gradients introduced by the pres...

The transmission of energy across the interface of a gold film with bulk sapphire has been studied using a metallic magnetic calorimeter. The transfer of energy by both high frequency and thermal phonons is found to be dependent upon the thickness of the gold film. For high frequency phonons the thickness dependence occurs when the size of the attenuation length in gold becomes comparable to the thickness. When the wavelength of the thermal phonons is larger than the thickness of the film, the density of modes of such phonons is altered from that of the bulk and the energy transmission is decreased.