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Das Prostatakarzinom stellt die am haufigsten diagnostizierte Krebserkrankung in der mannlichen Bevolkerung dar. Die genaue Atiologie ist nach wie vor nicht genau bekannt. Verschiedene Faktoren werden diskutiert, u. a. hormonelle Faktoren, Ernahrung, Infektionen und Umweltfaktoren. Als gesichert gilt ein erhohtes individuelles Risiko bei familiarer Belastung.

Die Prostata (Vorsteherdruse) ist ein kastaniengroses Organ, das dem Blasenboden anliegt und den proximalen Teil der Harnrohre umschliest. Sie wiegt rund 20-25 g und besteht aus glandularen und fibromuskularen Anteilen. Die ausere Form ist annahernd pyramidenformig, wobei die Basis prostatae zur Harnblase und der Apex prostatae nach kaudal weist.

Nach erfolgter transurethraler Resektion der Prostata (TUR-P) dient die transrektale Sonographie dem Abschatzen der Restdruse (◘ Abb. 20.1 bis ◘ Abb. 20.3). Dies ist v. a. bei wiederkehrenden Miktionsbeschwerden wichtig.

With increasing economic pressure on health care, modern hospital management is focusing at industrial optimization techniques to improve efficiency while maintaining quality. Shop floor management, a technique of code-based, process-oriented guidance directly on site is a method of lean management intended to increase efficiency in the operating room. In the literature, there is only scant evidence that the introduction of this technique alone can increase efficiency. The aim of this retrospective study is to determine whether a single tool alone can significantly improve codes. We performed an empirical, retrospective analysis of a number of codes from 3800 operations during two periods of comparison: upon introduction of shop floor management, and one year thereafter. Data was extracted from the Hospital Information System and transferred to a database. There was no statistically significant change in the relevant codes chosen, whether specific to the operating room (turnover time, first patient in the room, waiting times for anesthesia and surgery (p = 0.637) or to planning stability (scheduled, cancelled (p = 0.505), unscheduled and total operations performed (p = 0.984)). There were absolute changes, such as a reduction in the turnover time from 17:37 min to 16:26 min, even though not statistically significant (p = 0.238). Implementation of shop floor management as a single intervention is not appropriate to achieve a significant, continuous improvement in codes. A combination with other techniques such as detailed process analyses is definitely required. This could be important additional information for units using Lean Health Care strategies.

Total mesorectal excision (TME) has become the standard treatment for rectal cancer in the middle and lower third. Meanwhile, many international trials have confirmed the noninferiority of laparoscopic TME compared to the open technique. Nevertheless, in the presence of anatomical limitations, such as narrow, obese, male pelvises as well as large rectal tumors, the adequate resection of the lower third of the rectum according to oncological criteria, is still challenging even for specialized colorectal surgeons. Therefore, the implementation of innovative approaches, such as robotic-assisted and transanal TME (TaTME) should shed light on this anatomically complex region and guarantee an oncological radical resection and the best possible preservation of neural structures. The advantages of this technique have so far only been provided by retrospective cohort studies by large international centers. Therefore, international prospective randomized trials are currently recruiting patients to analyze the surgical and oncological outcome of TaTME compared to conventional techniques. This article describes the TaTME technique per se, the fields of application and the current data situation. Practical recommendations for the safe implementation of this operative procedure are also presented. The TaTME procedure is reserved for highly specialized colorectal centers with a high volume of rectal cancer cases and appropriate expertise in minimally invasive visceral surgery.Die totale mesorektale Exzision (TME) ist der Goldstandard im Kontext der multimodalen Behandlung des Rektumkarzinoms im mittleren und unteren Drittel. Der transanale Zugang ist eine Ergänzung des zunehmend laparoskopischen Vorgehens, welcher gerade bei anatomischen Limitationen bei der onkologisch adäquaten Resektion des distalen Rektums Abhilfe schaffen soll. Die Nichtunterlegenheit in chirurgischen und onkologischen Parametern wird gegenüber konventionellen (laparoskopisch/offen) Operationsmethoden derzeit intensiv beforscht. Eine sichere Implementation dieser herausfordernden Technik ist an ein modulares Trainingskurrikulum gebunden.

Das Prostatakarzinom ist das haufigste Karzinom des Mannes. Die Diagnose erfolgt ublicherweise durch eine systematische Prostatabiopsie. Dies ist aber ein randomisierter Ansatz, bei dem eine betrachtliche Anzahl signifikanter Karzinome nicht erfasst werden. Deshalb wurden in den letzten Jahren bildgebende Techniken stetig weiterentwickelt, die eine Visualisierung und somit eine gezielte Biopsie ermoglichen. Die systematische Biopsie ist das Standardverfahren, um Prostatakarzinome nachzuweisen. Die Qualitat der Biopsie kann gesteigert werden, indem die Prostata wahrend der Biopsie auf das Vorliegen karzinomsuspekter Veranderungen untersucht wird. Dies kann durch den multiparametrischen transrektalen Ultraschall geschehen. Der multiparametrische Ultraschall erhoht im Rahmen der gezielten Biopsie die Detektionsrate signifikanter Prostatakarzinome bei gleichzeitig geringerer Detektion insignifikanter Karzinome. Allerdings sind die diagnostische Zuverlassigkeit und der Evidenzlevel des mpTRUS noch nicht hoch genug, um auf eine systematische Biopsie verzichten zu konnen. Der multiparametrische transrektale Ultraschall stellt bereits jetzt in der Hand eines geubten Untersuchers eine gute Methode zur Detektion von Prostatakarzinomen dar. Mit der fortschreitenden technischen Entwicklung der Ultraschallgerate wird die Detektionsrate vermutlich weiter steigen.

Individualized and tailored treatment plays a crucial role in the rating of special operation techniques or certain treatment strategies following defined quality criteria and indicators. Deviations from clearly defined recommendations in guidelines must therefore be justified, documented and evaluated as precisely as possible. The aim of this leading article is to examine the individualized treatment of rectal cancer based on existing evidence and to discuss its role in the light of routinely used treatment algorithms. In addition to a web-based literature search the current German national S3 guidelines on colorectal cancer were also included. In the treatment of cancer in the middle and lower third of the rectum, individual, patient and tumor-related parameters are of decisive importance from the pretreatment stage to the actual surgery up to aftercare and adjuvant therapy to enable interdisciplinary decision making for optimal treatment.

We report the case of a 72-year-old woman who was diagnosed in 2006 with renal cell cancer (RCC) and had undergone consecutive tumor nephrectomy (clear-cell RCC, Fuhrmann grade II, stage pT3a, R0). Over the years, the patient underwent several surgical and radiological interventions due to various metastatic lesions. This case report describes the 3-year progression-free survival in a patient who underwent first-line therapy with the monoclonal antibody bevacizumab. Except for hypertension, the patient does not suffer currently from any other side effects of bevacizumab therapy.

Summary Volatile anaesthetics such as sevoflurane attenuate inflammatory processes, thereby impacting patient outcome significantly. Their inhalative administration is, however, strictly limited to controlled environments such as operating theatres, and thus an intravenously injectable immunomodulatory drug would offer distinct advantages. As protective effects of volatile anaesthetics have been associated with the presence of trifluorinated carbon groups in their basic structure, in this study we investigated the water-soluble sevoflurane metabolite hexafluoro-2-propanol (HFIP) as a potential immunomodulatory drug in a rat model of endotoxic shock. Male Wistar rats were subjected to intravenous lipopolysaccharide (LPS) and thereafter were treated with HFIP. Plasma and tissue inflammatory mediators, neutrophil invasion, tissue damage and haemodynamic stability were the dedicated end-points. In an endotoxin-induced endothelial cell injury model, underlying mechanisms were elucidated using gene expression and gene reporter analyses. HFIP reduced the systemic inflammatory response significantly and decreased endotoxin-induced tissue damage. Additionally, the LPS-provoked drop in blood pressure of animals was resolved by HFIP treatment. Pathway analysis revealed that the observed attenuation of the inflammatory process was associated with reduced nuclear factor kappa B (NF-κΒ) activation and suppression of its dependent transcripts. Taken together, intravenous administration of HFIP exerts promising immunomodulatory effects in endotoxaemic rats. The possibility of intravenous administration would overcome limitations of volatile anaesthetics, and thus HFIP might therefore represent an interesting future drug candidate for states of severe inflammation.

Hintergrund: Der PPROM (Preterm Prelabor Rupture of Membranes) ist als Blasensprung vor der vollendeten 37. SSW (Schwangerschaftswoche) definiert. Er geht etwa einem Drittel der Fruhgeburten voraus. Eine intrauterine Infektion kann sowohl Ursache als auch Folge des PPROM sein, weshalb der Entzundungsstatus zu evaluieren ist. Dies kann u.a. mit Hilfe von Zytokinen im Fruchtwasser geschehen. Methoden: Die vorliegende prospektive Studie befasste sich mit einer potenziellen Monitoringmasnahme beim PPROM, welche eine nichtinvasive Methode zur Fruchtwassergewinnung mit der Zytokinmessung mittels Bedside-Assessment kombinierte. Hierfur sammelten konservativ behandelte Probandinnen mit PPROM von SSW 23+0 bis SSW 33+6 ihre Vorlagen vom Zeitpunkt des PPROM bis zur Geburt. Taglich wurden die innerhalb von 24 Stunden gesammelten Hygienebinden mit Hilfe einer Presse ausgedruckt und das abgehende Fruchtwasser somit gewonnen. Die Zytokine im Fruchtwasser wurden mit Lateral Flow Immunoassay als POC (Point-Of-Care) Test, welcher innerhalb von 20 Minuten Ergebnisse liefert, und ELISA (Enzyme-Linked Immunosorbent Assay) quantitativ bestimmt. Ihr Zusammenhang mit maternalen Parametern wurde untersucht. Ergebnisse: Die nichtinvasive Fruchtwassergewinnung mit einer Presse war bei 65% der Schwangeren durchfuhrbar. Die tagliche Probengewinnung vom PPROM bis zur Geburt konnte dabei erstmalig uber mehrere Wochen hinweg vollzogen werden. Zur sequenziellen Zytokinmessung waren sowohl ELISA (IL-6, IL-8, TNFα) als auch der POC Test (IL-6) geeignet. Zwischen den IL-6 Konzentrationen im Vaginalsekret gemessen mit ELISA und POC Test zeigte sich eine signifikante, stark positive Korrelation (r=0.88, p≤ .0001). Sie war bei blutig tingierten Proben schwacher als bei unblutigem Vaginalsekret (r=0.38, p≤ .05 vs. r=0.89, p≤ .0001). POC Test und ELISA lieferten signifikant unterschiedliche IL-6 Werte (p≤ .0001). Die Ergebnisse des POC Tests waren niedriger. Es konnten Entzundungsprofile fur IL-6, IL-8 und TNFα im Zeitverlauf erstellt werden. Bei der Betrachtung der Zytokinwerte von IL-6 und IL-8 zeigte sich eine stark positive Korrelation sowie eine Ubereinstimmung der Graphen uber 14 Tage hinweg. Die Zusammenschau von maternalen Entzundungsparametern und Klinik der Schwangeren im Verlauf lies Schlusse auf mogliche Ursachen fur einen Anstieg von IL-6 im Vaginalsekret und CRP im Serum zu, ein einheitliches Schema konnte dabei nicht eruiert werden. Die IL-6 Konzentration im Vaginalsekret gemessen mit ELISA zeigte eine signifikante, schwach positive Korrelation mit dem mutterlichen CRP im Serum (r=0.24, p≤ .01). IL-6 zeigte weder gemessen mit ELISA noch mit POC Test eine Korrelation mit mutterlichen Leukozyten. Schlussfolgerung: Die vorliegenden Ergebnisse zeigen, dass die verwendete Methode zur nichtinvasiven Fruchtwassergewinnung in Kombination mit der Zytokinmessung mittels POC Test bei ausreichendem Fruchtwasserabgang und nach Ausschluss von Blutbeimengungen als potenzielle Monitoringmasnahme beim PPROM im klinischen Alltag geeignet ist. Um den genauen klinischen Nutzen dieses Monitorings abschliesend zu beurteilen sind weitere Arbeiten mit einer groseren Studienpopulation notig.

Prostate cancer is the most frequent cancer in men. The diagnosis is normally achieved by a systematic prostate biopsy; however, this is a randomized approach by which a substantial number of significant carcinomas go undetected. For this reason, in recent years imaging techniques have been continuously developed, which enable visualization and therefore targeted biopsies.The use of systematic biopsies is a standard procedure for the detection of prostate cancer. The quality of biopsies can be increased if the prostate is examined for the presence of suspected cancerous alterations during the biopsy. This can be carried out using multiparametric transrectral ultrasound.Multiparametric ultrasound within the framework of a targeted biopsy increases the detection rate of significant prostate carcinomas with a simultaneous decrease in detection of insignificant carcinomas; however, the diagnostic reliability and the evidence level of multiparametric transrectal ultrasound are not yet sufficiently high to be able to replace a systematic biopsy.In the hands of a well-trained examiner multiparametric transrectal ultrasound represents a good method for detection of prostate carcinomas. With the progression in technical developments of ultrasound technology, the detection rate will presumably be further increased.

Klinisches/methodisches Problem Das Prostatakarzinom ist der am haufigsten diagnostizierte Krebs bei Mannern. Die derzeitige Diagnostik basiert auf 3 Saulen: prostataspezifisches Antigen, digital-rektale Untersuchung (DRU) und die TRUS-gefuhrte systematische Biopsie. Diese Verfahren haben wesentliche Limitationen, welche in einer hohen Anzahl von unnotigen systematischen Biopsien resultiert. Diese sind mit einer Morbiditat und Kosten verbunden.

Randomisierte Biopsien unter transrektalem Ultraschall sind der goldene Standard in der Prostatakarzinomdiagnostik. Mit dem technischen Fortschritt sowohl in der konventionellen B-Bild-Ultraschallqualitat als auch durch den Einsatz neuerer komplementarer Methoden zum transrektalen Ultraschall eroffnen sich in der Diagnostik neue Moglichkeiten hinsichtlich einer moglichen fruheren und gezielteren Diagnostik. Eine dieser Methoden stellt die ultraschallbasierte Echtzeitelastographie dar, deren Stellenwert noch nicht ganzlich geklart ist, die Ansatze jedoch viel versprechend erscheinen. Die Anzahl der Publikationen deuten auf ein wachsendes Interesse an diese Technik und deren Einsatz hin.

It is well known that prostate cancer (PCa) has a higher cell density than the surrounding normal tissue. This increased cell density leads to an alteration in tissue elasticity, which can be measured and displayed by sonographic-based elastography under real-time conditions. Real-time sonoelastography (RTE) has been proven capable to visualize PCa areas as "hard" lesions and therefore can be used for PCa detection and for targeted ultrasound-guided biopsy. Further applications such as the assessment of local extent of PCa should be considered. This overview describes the capabilities, advantages, and limitations of this new ultrasound technique for PCa diagnosis.

Background A variety of therapeutic approaches are available for faecal incontinence. Implantation of Gatekeeper™ prostheses is a new promising option. The primary endpoint of this prospective observational multicentre study was to assess the clinical efficacy of Gatekeeper™ implantation in patients with faecal incontinence. Secondary endpoints included the assessment of patients' quality of life, and the feasibility and safety of implantation. Methods Patients with faecal incontinence, with either intact sphincters or internal anal sphincter lesions extending for less than 60° of the anal circumference, were selected. Intersphincteric implantation of six prostheses was performed. At baseline, and 1, 3 and 12 months after implantation, the number of faecal incontinence episodes, Cleveland Clinic Faecal Incontinence, Vaizey and American Medical Systems, Faecal Incontinence Quality of Life Scale and Short Form 36 Health Survey scores were recorded. Endoanal ultrasonography was performed at baseline and follow‐up. Results Fifty‐four patients were implanted. After Gatekeeper™ implantation, incontinence to gas, liquid and solid stool improved significantly, soiling was reduced, and ability to defer defaecation enhanced. All faecal incontinence severity scores were significantly reduced, and patients' quality of life improved. At 12 months, 30 patients (56 per cent) showed at least 75 per cent improvement in all faecal incontinence parameters, and seven (13 per cent) became fully continent. In three patients a single prosthesis was extruded during surgery, but was replaced immediately. After implantation, prosthesis dislodgement occurred in three patients; no replacement was required. Conclusion Anal implantation of the Gatekeeper™ in patients with faecal incontinence was effective and safe. Clinical benefits were sustained at 1‐year follow‐up., GatekeeperTM effective

Typically both breast and prostate cancer present as tissue with decreased elasticity. Palpation is the oldest technique of tumor detection in both organs and is based on this principle. Thus an operator can grade a palpable mass as suspicious for cancer. Strain elastography as modern ultrasound technique allows the visualization of tissue elasticity in a color coded elastogram and can be understood as technical finger. The following article shows similarities and differences of ultrasound strain elastography in the diagnosis of breast and prostate cancer. Key Points: • In prostata cancer elastography, in breast cancer B-mode is the primary sonographic search modality. • The diagnostic value of the search modalities change with increasing age. • A cut-off value for a strain ratio is hard to obtain in the elastography of the prostata, because there is no stabile reference tissue in the prostata. Citation Format: • Daniaux M, Auer T, De Zordo T et al. Strain Elastography of Breast and Prostata Cancer: Similarities and Differences. Fortschr Rontgenstr 2016; 188: 1 – 6

We report the case of a 72-year-old woman who was diagnosed in 2006 with renal cell cancer (RCC) and had undergone consecutive tumor nephrectomy (clear-cell RCC, Fuhrmann grade II, stage pT3a, R0). Over the years, the patient underwent several surgical and radiological interventions due to various metastatic lesions. This case report describes the 3-year progression-free survival in a patient who underwent first-line therapy with the monoclonal antibody bevacizumab. Except for hypertension, the patient does not suffer currently from any other side effects of bevacizumab therapy.

AIM: Magnetic resonance imaging, computed tomography, endorectal and endoanal sonography are used for imaging of inflammatory and neoplastic conditions of the lower rectum, the anus and the perineum. These methods, however, have their limitations regarding accuracy, cost-effectiveness, and availability in the acute setting. Pain may be a limiting factor when introducing a probe into the anus. Percutaneous transperineal sonography is an acknowledged method for diagnosing anorectal malformations in children and infants and for diagnosis of prostatic disease. Until today, only limited reports regarding the value of transperineal sonography for evaluation of diseases of the lower rectum, the anus and the perianal region in adults are available. PATIENTS AND METHODS: Between 1997 and 2000 a total of 44 patients underwent transperineal sonography including B-mode and colour Doppler sonography for imaging anorectal structures using 3.5 MHz sector arrays and 7 MHz linear arrays. The lesions were also investigated using colour Doppler imaging. During examination the patient is positioned on his side. Orientation landmarks are the pubic symphysis and the prostate gland in men and the vagina in women. RESULTS: The spectrum of diseases of the current study population (44) included perianal fistulas (10), pararectal abscesses (7), fistulas with abscess (7), perianal inflammation without abscess (1), rectal (6) and anal carcinomas (3) and metastasis of a leiomyosarcoma (1). In 10 cases digital examination of the anus and rectum was not possible because of intense pain. In 34 patients (85 %) sonographic findings were confirmed by intraoperative diagnosis. CONCLUSION: Transperineal sonography proved to be an inexpensive, easily available diagnostic tool that may help in detecting a variety of pathological conditions of the lower rectum, the anus, and the perianal region.

Technical fusion is defined as the ultrasound-guided navigation through a previously generated 3 D imaging dataset such as a computed tomography (CT) or magnetic resonance imaging (MRI). This technique allows for moving the fused CT/MRI datasets synchroneously with the real-time ultrasound in the same plane. Established and furthermore not yet described applications, the technical principles and the limitations of this promising technique will be introduced. Key points: • improves detection rates of lesions on ultrasound • more reliable size controls at different time points • may be an alternative to in bore biopsies • can be used for focal therapy Citation Format: • Aigner F, De Zordo T, Pallwein-Prettner L et al. Applications of Technical Fusion in Uroradiology. Fortschr Rontgenstr 2015; 187: 331 – 337

Der rechnerische Nachweis von Stahlbetonquerschnitten, die sehr grosen Temperaturgradienten ausgesetzt sind, wird anhand eines einfachen Stabmodells gefuhrt. In ungestorten Wandbereichen konnen die Stahlspannungen und Ristiefen in Grenzen gehalten werden, in Storzonen jedoch nur durch Anordnung eines durchgehenden Isolierliners. Masgebend ist die Ringrichtung, da aus Flussigkeitsdruck und Innendruck zentrische Zugkrafte entstehen, die Trennrisse hervorrufen konnen und durch eine Ringvorspannung aufzunehmen sind. Eine Vertikalvorspannung ist ublicherweise verzichtbar. Die Untersuchungsergebnisse sind in Nachweisdiagrammen dargestellt.

Um die Vorzuege der Gewoelbewirkung ausnutzen zu koennen, sollten Bogentragwerke eine stuetzliniennahe Form erhalten. Es wird eine baustatische Methode fuer die Einrechnung von Bogenachsen massiver Bogenbruecken gezeigt. Neben Boegen mit abgesetztem Tragwerk lassen sich auch Boegen einrechnen, bei denen der Bogen in das Tragwerk einschneidet. Aus statischen und wirtschaftlichen Gruenden ist der Kastenquerschnitt dem Vollquerschnitt klar ueberlegen, dieser ist nur fuer kleinere Boegen, etwa 40 bis 50 m Stuetzweite, vertretbar. Fuer Boegen mit veraenderlicher Querschnittshoehe werden einfache Gesetze fuer den Hoehenverlauf angegeben. (A)

We investigate the role of disorder and diffractive scattering in the shot noise power of quantum transport through a two-dimensional quantum dot. By tuning the strength of the disorder potential and the openings of the dot, we numerically explore the influence of quantum scattering mechanisms on the current shot noise. For small cavity openings we find the shot noise for disordered samples to be of almost equal magnitude as for clean samples where transport is ballistic. We explain this finding by diffractive scattering at the cavity openings which act as strong noise sources. Estimates for the shot noise induced by both the disorder potential and the diffractive openings are presented that agree with the numerical data.

Prostate cancer is the most common cancer in men. The diagnosis is based on prostate-specific antigen (PSA), digital rectal examination (DRE) and transrectal ultrasound (TRUS) guided biopsy. These techniques have considerable limitations, which result in unnecessary biopsies. Furthermore the biopsies are associated with morbidity and costs.Standard gray-scale ultrasound has a low sensitivity and specificity for prostate cancer detection.New ultrasound technologies, including color- and power Doppler ultrasound, contrast enhanced US and real-time sonoelastography have shown to improve prostate cancer diagnosis.Contrast-enhanced ultrasound has shown a sensitivity of 100% (95% CI, 95%), a negative predictive value (NPV) of 99.8% and a positive predictive value (PPV) of 88.8% for prostate cancer detection. Real-time sonoelastography has shown a sensitivity of 86%, a specificity of 81% and NPV of 91% for prostate cancer diagnosis.Most studies show that these new ultrasound modalities demonstrate a 1.5 to 2.5 times higher detection of prostate cancer per biopsy specimen compared with systematic biopsy. Multicenter studies results are at present lacking but are, however ongoing.In patients with suspected prostate cancer (elevated PSA, suspicious DRE) these new ultrasound techniques should be used. These techniques can detect prostate cancer and allow a targeted biopsy approach.

P. Tiwald,1 A. Schuller,2 H. Winter,2 K. Tokesi,3 F. Aigner,1 S. Grafe,1 C. Lemell,1 and J. Burgdorfer1 1Institute for Theoretical Physics, Vienna University of Technology, Wiedner Hauptstrase 8-10, A-1040 Vienna, Austria, EU 2Institut fur Physik, Humboldt-Universitat zu Berlin, Newtonstr. 15, D-12489 Berlin-Adlershof, Germany, EU 3Institute of Nuclear Research of the Hungarian Academy of Sciences (ATOMKI), P.O. Box 51, H-4001 Debrecen, Hungary, EU Received 11 June 2010; published 29 September 2010

PURPOSE We assessed the value of contrast-enhanced US for differentiating between benign and malignant axillary lymph nodes in breast cancer. MATERIALS AND METHODS A total of 120 axillary lymph nodes in 92 patients with breast cancer were studied. All patients underwent grayscale US examination, unenhanced and enhanced color and power Doppler US, and enhanced grayscale harmonic US examination. RESULTS The mean size of the 120 axillary lymph nodes was 1.5 cm (range 0.5 - 3.4 cm). Of all 120 axillary lymph nodes studied, 80 (67 %) were malignant and 40 (33 %) were benign according to pathological examination. The total number of vessels in baseline US did not increase between benign and malignant lymph nodes (3.3 +/- 2.2 vs. 5.4 +/- 4.0; p > 0.05). The total number of peripheral vessels was 0.5 +/- 0.8 for benign lymph nodes vs. 2.0 +/- 1.7 for malignant lymph nodes (p > 0.05). Enhanced US studies showed enhancement in both benign and malignant lymph nodes after contrast administration with a significantly higher degree of enhancement in malignant lymph nodes (p < 0.01). The total number of vessels was significantly higher in malignant lymph nodes after contrast administration (17.3 +/- 8.0 vs. 8.2 +/- 5.1, p < 0.01). Malignant lymph nodes demonstrated longer contrast enhancement duration compared to benign lymph nodes. CONCLUSION This preliminary data shows that contrast-enhanced US can differentiate between benign and malignant lymph nodes in breast cancer.

Quantum diffraction of fast atoms scattered from the topmost layer of surfaces under grazing angles of incidence can be employed for the analysis of detailed structural properties of insulator surfaces. From comparison of measured and calculated diffraction patterns we deduce the rumpling of the topmost surface layer of LiF(001) (i.e., an inward shift of Li(+) ions with respect to F(-) ions). The effect of thermal vibrations on the measurement of rumpling is accounted for by ab initio calculations of the mean-square vibrational amplitudes of surface ions. At room temperature this leads to a reduction of the apparent rumpling by 0.008 angstrom. We then obtain a rumpling of ( 0.05 +/- 0.04) angstrom, which improves its accuracy achieved in previous work.

Randomized biopsy sampling under transrectal ultrasound (TRUS) guidance is the gold standard for the diagnosis of prostate cancer. In addition improvements in the quality of conventional ultrasound, new methods that complement conventional TRUS are opening the door to earlier and better targeted diagnosis of prostate cancer. One of these new methods is sonoelastography. Its impact on prostate cancer diagnostics has not yet been fully investigated, but the number of publications on this new technique indicate increasing interest in it.