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Zusammenfassung Hintergrund Obwohl urologische Facharztpraxen zentraler Pfeiler der ambulanten Patientenversorgung in Deutschland sind, fehlen hierzu aktuelle Daten. Eine Beschreibung der Strukturen in Großstädten gegenüber dem ländlichen Raum sowie von Gendereffekten und Generationsunterschieden ist auch als Ausgangsbasis für weitere Untersuchungen erforderlich. Material und Methoden Die Erhebung umfasst Daten des Arztverzeichnisses der Stiftung Gesundheit sowie der Bundesärztekammer und des Statistischen Bundesamtes. Die erfassten Praxen bzw. Kolleg*innen wurden in Subgruppen eingeteilt. Anhand der unterschiedlichen Subgruppengröße lassen sich Aussagen über die Versorgungsstruktur der ambulanten Urologie in Deutschland treffen. Ergebnisse Während in größeren Städten die Mehrheit der niedergelassenen Urolog*innen in Berufsausübungsgemeinschaften (BAG) arbeitet und durchschnittlich weniger Patient*innen betreut, zeigt sich im ländlichen Raum ein besonders hoher Anteil an Einzelpraxen mit mehr zu versorgenden Einwohnern pro Urolog*in. Urologinnen arbeiten häufiger in der stationären Versorgung. Wenn sich Fachärztinnen für Urologie für die Niederlassung entscheiden, dann eher in BAG und eher in städtischen Gebieten. Außerdem zeigt sich eine Verschiebung der Geschlechterverteilung: Je jünger die betrachtete Alterssubgruppe, desto höher liegt der Anteil an Urologinnen unter allen Kolleg*innen. Schlussfolgerung Wir beschreiben erstmalig die tatsächliche Versorgungsstruktur der ambulanten Urologie in Deutschland. Hierbei deuten sich Trends an, die die Art zu arbeiten und die Patientenversorgung in einigen Jahren maßgeblich beeinflussen werden.

In the care for patients with urological diseases, outpatient urology secures a near-to-home treatment by specialists in urology and is located between general practitioner and urological clinic. Comparably little is known about the structure and fields of work in this area of urology. A survey of the EAU Section ESUO of outpatient and office urology ( https://uroweb.org/section/esuo/ ) shows the diversity in terms of content and organisation of this sector in Europe, in which more than 16,500 outpatient urologists and thus about half of all professional urologists work full-time. This diversity is related to the diagnostic and therapeutic methods in outpatient urology and to the working conditions of outpatient urologists. For comparison, this information about European countries is contrasted with data from the German office urology as one type of outpatient urology.

In the care for patients with urological diseases, outpatient urology secures a near-to-home treatment by specialists in urology and is located between general practitioner and urological clinic. Comparably little is known about the structure and fields of work in this area of urology. A survey of the EAU Section ESUO of outpatient and office urology ( https://uroweb.org/section/esuo/ ) shows the diversity in terms of content and organisation of this sector in Europe, in which more than 16,500 outpatient urologists and thus about half of all professional urologists work full-time. This diversity is related to the diagnostic and therapeutic methods in outpatient urology and to the working conditions of outpatient urologists. For comparison, this information about European countries is contrasted with data from the German office urology as one type of outpatient urology.In der Versorgung von Patienten mit urologischen Erkrankungen sichert die ambulante Urologie eine meist wohnortnahe Behandlung durch urologische Fachärzte und steht damit zwischen Hausarzt und urologischer Klinik. Trotz dieser wichtigen Aufgabe ist vergleichsweise wenig über Struktur und Tätigkeitsfeld dieses Sektors dokumentiert. Eine Befragung der EAU Section of Outpatient and Office Urology (ESUO; https://uroweb.org/section/esuo/ ) zeigt die inhaltliche und organisatorische Vielfalt dieses Sektors in Europa, in dem immerhin über 16.500 ambulante Urologen und damit etwa die Hälfte aller berufstätigen Urologen hauptberuflich arbeiten. Diese Vielfalt bezieht sich auf die diagnostischen und therapeutischen Methoden in der ambulanten Urologie und auf ihre Arbeitsbedingungen. Den Informationen aus europäischen Ländern werden Daten aus der deutschen Praxisurologie als einer Spielart der ambulanten Urologie zum Vergleich gegenübergestellt.

Schon jetzt kommt aus der Deutschen Gesellschaft fur Urologie (DGU) hochwertige Fortbildung bei Kongressen, Tagungen und in Zeitschriften, seit April nun auch online unter www.uro-tube.de . Im Interview erklart Prof. Dr. Helmut Haas, einer der Geschaftsfuhrer der DGU-Akademie GmbH, die Fortbildungsmoglichkeiten auf uro-tube.

Dextrocardia refers to the position of the heart in the right side of the chest. It is a rare clinical phenomenon with a reported incidence of 1 in 5,000-30,000. Although there is a variation in terminology and classification with regard to dextrocardia, the condition of right-sided heart with situs solitus is most commonly referred to as dextroversion. The authors report the case of dextroversion in a patient who presented in their hospital for evaluation of chest pain on exertion. Cardiac catheterization produced unfamiliar angiographic images, but there was no severe technical problem during coronary angiography. Apart from dextroversion, no further cardiac or noncardiac anomaly was found.

Background: The 2S albumins are a group of storage proteins that occur widely in seeds of dicotyledonous plants. The widespread distribution and stability to digestion of allergenic 2S albumins raise the question of why some members of this family present in important food sources, such as soybean, are not regarded as major allergens. Methods: The pepsinolytic stability of two 2S albumins from soybean seed was determined using simulated gastric fluid. Using a new protein microarray system, IgE binding to these soybean 2S albumins was studied with the sera from 23 European individuals allergic to soybean. In order to validate the microarray result, two of the sera were selected and further tested using the micro-ELISA and UniCAP system. Results: Both albumins exhibited high stability to digestion similar to other allergenic members of the 2S albumin, trypsin/amylase inhibitor and lipid transfer protein superfamily. None of the patients was found to have IgE specific to soybean 2S albumins by the microarray system, and this result was in agreement with the results from the micro-ELISA and UniCAP system.Conclusions: The results from microarray, micro-ELISA and UniCAP system suggested that the 2S albumins from soybean are not major allergens within the patient population analyzed.

In a previous study using the monoclonal anti-CD26 antibody MIB-DS2/7 in leprosy and other granulomatous diseases, it was shown that CD26 may be a candidate for use as an operational marker of a human Th1-like reaction. In this follow-up study, we compared seven different monoclonal anti-CD26 antibodies with respect to their staining pattern in lepromatous and tuberculoid leprosy tissues. Three distinct staining patterns became apparent in this anti-CD26 antibody panel: staining of T-lymphocytes and of connective tissue; staining of T-lymphocytes, connective tissue and macrophages; and almost no staining of T-lymphocytes but staining of connective tissue and macrophages. The two antibodies assigned to the first staining pattern, including MIB-DS2/7, were found to be most suitable for the operational discrimination between Th1-like and Th2-like reactions in leprosy. The antibodies assigned to staining patterns 2 and 3 did not allow this discrimination. Although all seven monoclonal antibodies investigated were specific for CD26, only two were found to be useful in identifying a Th1-like immune reaction in human tissue.

Multinucleated giant cells (MGCs) are a key feature of granulomas. They have been studied with respect to the mechanism and regulation of their formation, but the function of these cells still remains elusive. A new method for the in vitro generation of granulomas was developed and characterized in which L3 larvae of Nippostrongylus brasiliensis, as a target for the cellular response, were co-incubated with human mononuclear blood cells. The development of epithelioid cells and MGCs was observed and single isolated MGCs were analysed by the reverse transcriptase polymerase chain reaction method. The presence of tumour necrosis factor alpha (TNFα), interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and inducible nitric oxide synthase (iNOS) transcripts in MGCs was demonstrated. It is proposed that MGCs in the granuloma model may in part represent an active cellular constituent involved in granuloma formation and turnover and in the destruction of the irritant. © 1997 John Wiley & Sons, Ltd.

Little is known whether and to what extent antiparasitic treatment cures female genital schistosomiasis (FGS). Using a standard protocol, of twenty-one women with FGS nine were re-examined at two to nine weeks after they had been treated with praziquantel at a single dose of 40 mg/kg. Symptoms related to pathology of the urinary tract and to a lesser extent of genital pathology subsided in most patients. Schistosoma haematobium ova were no longer detectable in urine of any of the patients post-treatment. Efficiency of chemotherapy against adult worms was confirmed by the disappearance of circulating anodic antigen (CAA) in serum. Sandy patches showed resolution in two of four cases after chemotherapy. Papillomata due to schistosomiasis alone improved, but persisted in mixed infection with human papilloma virus (HPV) or when HPV was the only underlying cause. In one patient ulcera could not be related with certainty to schistosomiasis at admission, but resolved after treatment with parziquantel. Leukoplakia (two cases) was not influenced by chemotherapy, or even increased during follow-up, regardless of whether ova had been detected or not. Although the follow-up period was rather short, time intervals were not standardized, and a relatively small number of patients was investigated, it could be shown that genital pathology due to sequestered S. haematobium ova is, at least partially, reversible already two to nine weeks after killing the adult worms by praziquantel. This is paralleled by a normalization of inflammatory immune responses detectable in histological sections and vaginal lavage.

Selenium surrounded by oxygen in a trigonal-bipyramidal arrangment-this unprecedented bonding pattern exists for Li4SeO5, the first orthoselenate (see picture). It crystallizes as an order variant of a predicted AB structure in which cations and anions are equally coordinated as A[5]B[5].

To determine the effects of intermittent hypoxemia on daytime sleepiness in the clinical setting of obstructive sleep apnea syndrome, we enrolled seven patients in a prospective, randomized, crossover study. We had two experimental conditions with NCPAP treatment as follow: (1) to correct apneas, sleep fragmentation, and hypoxemia; and (2) to correct apneas and sleep fragmentation and at the same time, induce intermittent hypoxemia. The outcome variable, daytime sleepiness, was measured objectively with the multiple sleep latency test following completion of baseline and each treatment condition. Compared with sleep latencies in the untreated condition, both experimental treatment arms prolonged sleep latencies (p less than 0.05). We found no statistically significant differences between mean MSLT scores obtained after NCPAP treatment under hypoxemic and nonhypoxemic conditions. In summary, two nights of intermittent nocturnal hypoxemia during NCPAP treatment for OSAS did not diminish the objective improvement in daytime somnolence seen with NCPAP treatment in the absence of nocturnal hypoxemia. Results lend further support to the hypothesis relating excessive daytime sleepiness to sleep fragmentation.

Selen trigonal-bipyramidal von Sauerstoff umgeben – diese prazedenzlose Bindungssituation besteht bei Li4SeO5, dem ersten Orthoselenat (siehe Bild). Es kristallisiert als Ordnungsvariante einer schon vorhergesagten AB-Struktur, in der sich Kationen und Anionen gemas A[5]B[5] gleichartig gegenseitig koordinieren.

Selenium surrounded by oxygen in a trigonal-bipyramidal arrangment-this unprecedented bonding pattern exists for Li4SeO5, the first orthoselenate (see picture). It crystallizes as an order variant of a predicted AB structure in which cations and anions are equally coordinated as A[5]B[5].

A 77-year-old man was admitted to our hospital for revision of his single-chamber ventricular pacemaker to a biventricular pacing device. He showed class 4 symptoms of congestive heart failure, a history of idiopathic dilated cardiomyopathy, chronic atrial fibrillation, a 15% ejection fraction during echocardiography, and left bundle-branch block with a QRS duration of 170 ms. At implantation, venography of the coronary …

The 2S albumins are a group of storage proteins that occur widely in seeds of dicotyledonous plants. The widespread distribution and stability to digestion of allergenic 2S albumins raise the question of why some members of this family present in important food sources, such as soybean, are not regarded as major allergens.The pepsinolytic stability of two 2S albumins from soybean seed was determined using simulated gastric fluid. Using a new protein microarray system, IgE binding to these soybean 2S albumins was studied with the sera from 23 European individuals allergic to soybean. In order to validate the microarray result, two of the sera were selected and further tested using the micro-ELISA and UniCAP system.Both albumins exhibited high stability to digestion similar to other allergenic members of the 2S albumin, trypsin/amylase inhibitor and lipid transfer protein superfamily. None of the patients was found to have IgE specific to soybean 2S albumins by the microarray system, and this result was in agreement with the results from the micro-ELISA and UniCAP system.The results from microarray, micro-ELISA and UniCAP system suggested that the 2S albumins from soybean are not major allergens within the patient population analyzed.

We described a complication during percutaneous coronary intervention. A bleeding into the left atrial wall occurred after stenting of the right coronary artery. Echocardiography revealed the diagnosis of a left atrial intramural hematoma. Conservative treatment was performed. After 4 weeks the hematoma resolved completely. Left atrial intramural hematoma as a complication after percutaneous coronary intervention has not been reported in the literature yet.

Selenium surrounded by oxygen in a trigonal-bipyramidal arrangment-this unprecedented bonding pattern exists for Li

The in vitro cultivation of the filarial nematode Brugia malayi from the infective stage to the fourth and the young adult stage is described. Different culture conditions including cell-free systems and coculture with different human lymphatic cell lines were compared. Cocultivation with each of the cell lines used enhanced the survival of the parasites. The best results were obtained employing the human T cell leukemia line Jurkat and human dermal fibroblasts as feeder cells in RPMI 1640 supplemented with 10% heat-in-activated human serum. This culture system allowed the cultivation of B. malayi for more than 7 weeks with an average growth of the larvae by factor 6.4 (0.77 +/- 0.035 cm) and a maximum growth by factor 10 (1.2 cm). 100% of the parasites reached the fourth larval stage after 14 days. By day 37 of culture, 17% of the larvae had completed their final moult. Parasites remained alive up to 52 days. During the first four weeks of culture, both the length and the periods of moulting of the in vitro cultivated filariae closely resembled those observed with B. malayi in vivo in rodent hosts. This system provides a new approach for successful cultivation of B. malayi, that should help to overcome the difficulties of reproduction by other laboratories encountered with previous culture systems. It appeared highly reproducible in our hands and possibly further improvement can be obtained on its basis. This cultivation system represents a further step towards the complete replacement of the vertebrate host by means of in vitro culture systems in parasitological research.

Peripheral blood human naïve B cells express high levels of CD23 and circulate pre-loaded with IgE. The antigen specificity of CD23-bound IgE presumably differs from the B cell receptor (BCR) and may reflect the antigen specific mix of free serum IgE. CD23-bound IgE is thought to enhance B cell antigen presentation raising the question of how a B cell might respond when presented with a variety of antigens and CD23-bound IgE specificities. We recently reported that an increase in CD23+ B cells is associated with resistance to schistosomiasis highlighting the potential importance of CD23-bound IgE in immunity. We sought to determine the relationship between BCR and CD23-bound IgE mediated B cell activation in schistosomiasis. Crude schistosome antigens downregulated basal B cell activation levels in individuals hyper-exposed to infectious worms. However, schistosome-specific IgE from resistant, occupationally exposed Kenyans recovered responses of naïve B cells to schistosome antigen. Furthermore, cross-linking of CD23 overrode intracellular signals mediated via the BCR illustrating its dominating role in B cell activation. Notably, the nature of the cognate antigen appeared to dictate the threshold of antigen-specific CD23-bound IgE required for B cell activation suggesting that CD23-bound IgE functions as a rheostat for B cell responses to antigenic stimuli. These results suggest that CD23-bound IgE augments and dominates host recall responses through naïve B cells.

A case report of embryonal rhabdomyosarcoma originating from the cervix in a 3-year-old girl is presented and a brief review of the literature on this topic given. The histopathology of the tumor is discussed and the effectiveness of a less aggressive surgical approach and chemotherapy is demonstrated in this particular case.

Dipeptidylpeptidase IV (DPP IV) occurs among others in exocrine epithelia, hepatocytes, renal tubuli, endothelia, and myofibroblasts of man and laboratory animals. Also T mu lymphocytes and their varying differentiated neoplastic counterparts reveal this enzyme activity. The present paper describes a new monoclonal antibody recognizing DPP IV. Additional efforts have been taken to detect the subcellular localization of DPP IV and its isoelectric focusing pattern in different tissue types. The monoclonal antibody anti-DPP IV (clone II-19) shows a reaction pattern indistinguishable from the corresponding enzymehistochemical reaction. These findings were further substantiated by immunoblotting analysis. In line with the results of direct enzyme measurements in different subcellular fractions a considerable portion of the enzyme is localized in the membrane fraction.

Reversible as well as irreversible relaxation processes have been found for glassy Cu-Ti, Ni-Zr and Pd-Zr alloys. The heat flow and the enthalpy changes connected with these processes have been determined. The kinetics of the relaxation processes and the activation energy spectrum obtained are discussed.

The relaxation behavior of glassy Fe-Ni-B alloys has been investigated by microcalorimetric measurements. The reversible relaxation enthalpies show a temperature and concentration dependence. The frequency factor for the relaxation processes obtained by crossover experiments amounts to about 1051 s−1. Activation energies for the relaxation processes obtained from isothermal measurements as well as from measurements with constant heating rate agree very well.

Twenty-four patients with chronic bronchopulmonary disease were studied to determine if measurements of breath alcohol accurately reflected blood-alcohol concentrations. After the patients consumed measured amounts of ethyl alcohol, blood-alcohol levels were determined by gas-liquid chromatography (GLC) and estimated by Breathalyzer analyses of expired air. In this study, the Breathalyzer method underestimated the results of GLC by approximately 15%. Similar differences in alcohol levels between blood and breath tests have been reported on populations not classified by pulmonary function. Pulmonary function impairment had no systematic effect upon breath-alcohol analysis. It is concluded that the Breathalyzer method is valid in the presence of chronic bronchopulmonary disease.