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Aims The present study was performed to investigate the contribution of NADPH oxidases (Nox) to superoxide formation in human renal proximal resistance arteries and to test whether superoxide formation contributes to acute vasoconstrictor responses and endothelium-dependent vasodilation in these vessels. Methods and results Arcuate and proximal interlobular artery segments were from patients who underwent nephrectomy because of a renal tumour. Vessels were dissected from tumour-free parts of the kidneys. Additional intrarenal arteries were obtained from rats. Superoxide formation was measured by lucigenin-enhanced chemiluminescence, expression of Nox isoforms was analysed by RT–PCR, and functional studies were performed by small vessel wire myography. Sixty per cent of superoxide formation in human arcuate and proximal interlobular arteries was due to Nox activity. mRNA expression analyses revealed the presence of Nox2 and Nox4 but not Nox1. Phenylephrine and endothelin-1 induced powerful concentration-dependent vasoconstrictions that were unaffected by superoxide scavengers. Vasopressin elicited small and variable vasoconstrictions with signs of tachyphylaxis. Endothelium-dependent vasodilation was blunted by tiron and N ω-nitro-l-arginine methyl ester but not by superoxide dismutase or catalase. Exogenous hydrogen peroxide elicited vasoconstriction. Conclusion Nox activity is the major source of superoxide formation in renal proximal resistance arteries from elderly patients. Acute vasoconstrictor responses to α1-adrenoreceptor activation and to endothelin-1 do not depend on superoxide formation, while endothelium-dependent vasodilation in intrarenal arteries is reactive oxygen species-dependent.

Einleitung Die Prognose des fortgeschrittenen Peniskarzinoms ist extrem schlecht. Aufgrund der schlechten Ansprechraten und erheblichen Nebenwirkungsraten der aktuellen Standardtherapien wurden in den letzten Jahren verschiedene neue Schemata zum Einsatz gebracht, um die Prognose des fortgeschrittenen Peniskarzinoms zu verbessern. Mittels einer retrospektiven Umfrage analysierten wir den aktuellen Standard der Chemotherapie des Peniskarzinoms in Deutschland.

A high prevalence and incidence of sexual dysfunctions as well as the availability of orally effective medications cause a rising interest in professional help. In diagnosing and treating sexual disorders, a holistic, biopsychosocial understanding of sexuality and a thorough analysis of the specific needs of the couple are of the utmost importance. Furthermore, the typical physician-patient relationship has to be transformed into a physician-couple relationship wherever possible. Sex therapy, then, focuses on the universal psychosocial fundamental needs and their relevance for the complaints of the couple. In this way the main focus of attention is shifted from the sexual dysfunction to the communicative meaning of sexuality within the relationship and to the quality of the partnership as a whole. Thus the sexual problem is put into a new perspective and sexual functions are relieved from the pressure of performance anxiety. Simultaneously intimacy and mutual satisfaction are promoted. The possibility of obtaining an additional qualification in sexual medicine (since 1997 in postgraduate, curricular trainings) is offering new opportunities for urologists to integrate aspects of sexual medicine into their clinical practice and thus to propose a more extensive form of therapy to their patients. This paper reflects the process of this integration, illustrating it with respective case reports; it stresses the necessity of a holistic approach to the treatment of sexual dysfunctions, also in regard to the economic advantages of a biopsychosocially oriented sex therapy.

To identify tumour-related enzyme alterations we have used 2D-gels to analyse the proteome from dissected malignant and benign kidney areas from patients with clear-cell-type renal carcinoma. The expression of 12 proteins was diminished in tumour. Four proteins were characterized by mass spectrometry and were identified as enoyl-CoA hydratase, α-glycerol-3-phosphate dehydrogenase, aldehyde dehydrogenase 1 and aminoacylase-I.

In a randomized clinical study, 61 hospitalized men were examined to test the local tolerability and antimicrobial efficacy of antiseptic treatment of the genitals with povidone iodine versus octenidine hydrochloride solution. Antibacterial efficacy was established by comparing the total aerobic bacterial colony count from standardized swabs from the orificium urethrae externum before, immediately after, and 30 and 60 min after antisepsis. Tolerability was assessed by dermatoscopy, applying a scale to rate the criteria of reddening, erosions and microbleeding. pH-value was taken and the nitracin yellow test carried out at several intervals. Patients assessed sensations (itching, burning, warmth, cold tension) in visual analogue scales. The test for equivalence in efficacy of both antiseptic agents produced no significant result (P = 0.3). The sum score of tolerability produced a better result for povidone iodine. In addition, the drop in the pH value after observed antisepsis with povidone iodine provides an additional protective mechanism against bacterial colonization.

We report a 44-year-old female patient who underwent surgery because of a suspected primary tumor of the renal pelvis in imaging procedures. Histology revealed the diagnosis of mesoblastic nephroma. This tumor represents a special entity of nephroblastoma that rarely occurs in adults. There is no unanimous opinion on the biological behavior of mesoblastic nephroma because the tumor behaves differently. The question of whether nephrectomy is indicated if there are no malignant features is also open. The decision depends on the given case. Nephrectomy can only be avoided if the intraoperative situation allows the tumor to be removed with an adequate distance from healthy tissue. The safety margin is necessary because mesoblastic nephroma shows fingerlike spread into the surrounding tissue.

The prognosis for advanced penile carcinomas is extremely poor. Due to the low response rates and relevant side effects of current chemotherapy regimens, several attempts have been made to improve chemotherapy in recent years. In a retrospective survey the current state of the art of chemotherapy for penile carcinoma in Germany was analysed.The study took the form of a retrospective survey among all urological departments in Germany. The questionnaire contained seven questions concerning indications and modalities for chemotherapy of penile carcinoma in addition to general questions.Out of 280 departments 129 (46%) returned an answered questionnaire. Chemotherapy was reported to be carried out by 91 of the answering departments and overall 18 different chemotherapy regimens were used. The regimens cisplatin/methotrexate/bleomycin, vinblastin/methotrexate/bleomycin and cisplatin/5FU were the most frequently reported. Chemotherapy was carried out on average 2.3 times per year per department. The majority of the departments reported response rates under 30%. Finally 101 of the answering departments confirmed the necessity of new chemotherapy regimens.The current state of the art for chemotherapy of penile carcinoma showed a very large variation in Germany. The response rates were disappointing. A nationwide study with new chemotherapy approaches is urgently needed (information under www.uni-rostock.de/peniskarzinom).

Treatment options for patients with end-stage renal disease (ESRD) and metastatic renal cell carcinoma (mRCC) are limited. We report the case of a 69-yr-old male who was treated with sorafenib after failure of immunotherapy. The treatment has resulted in remission with stable disease for 13 mo so far. Sorafenib seems to be a safe treatment option for patients with ESRD and mRCC, but further studies are required.

A high prevalence and incidence of sexual dysfunctions as well as the availability of orally effective medications cause a rising interest in professional help. In diagnosing and treating sexual disorders, a holistic, biopsychosocial understanding of sexuality and a thorough analysis of the specific needs of the couple are of the utmost importance. Furthermore, the typical physician-patient relationship has to be transformed into a physician-couple relationship wherever possible. Sex therapy, then, focuses on the universal psychosocial fundamental needs and their relevance for the complaints of the couple. In this way the main focus of attention is shifted from the sexual dysfunction to the communicative meaning of sexuality within the relationship and to the quality of the partnership as a whole. Thus the sexual problem is put into a new perspective and sexual functions are relieved from the pressure of performance anxiety. Simultaneously intimacy and mutual satisfaction are promoted. The possibility of obtaining an additional qualification in sexual medicine (since 1997 in postgraduate, curricular trainings) is offering new opportunities for urologists to integrate aspects of sexual medicine into their clinical practice and thus to propose a more extensive form of therapy to their patients. This paper reflects the process of this integration, illustrating it with respective case reports; it stresses the necessity of a holistic approach to the treatment of sexual dysfunctions, also in regard to the economic advantages of a biopsychosocially oriented sex therapy.

To identify tumour-related enzyme alterations we have used 2D-gels to analyse the proteome from dissected malignant and benign kidney areas from patients with clear-cell-type renal carcinoma. The expression of 12 proteins was diminished in tumour. Four proteins were characterized by mass spectrometry and were identified as enoyl-CoA hydratase, alpha-glycerol-3-phosphate dehydrogenase, aldehyde dehydrogenase 1 and aminoacylase-I.

Renal leiomyoma is a rare benign tumor which has its origin in smooth muscle cells of different structures of the kidney. The clinical incidence of renal leiomyoma is much lower than the frequency described in large autopsy studies. Renal leiomyomas are mainly located in the renal capsula and pelvis or next to those structures. Clinical symptoms are nonspecific (e.g., flank pain or flank tumor) or completely absent, making most of the leiomyomas an incidental finding during routine diagnostics. A differential diagnosis between renal leiomyoma and renal cell carcinoma on the basis of medical imaging is extremely difficult. Therefore, laparotomy and nephrectomy are performed in most cases of suspected renal cell carcinoma. The definitive diagnosis of a leiomyoma is only possible after histological examination of the tumor. Due to the rising number of diagnoses resulting from improved medical imaging, renal leiomyomas are gaining more importance in the differential diagnosis of renal cell carcinoma, especially with respect to kidney-sparing surgery.

We report a 44-year-old female patient who underwent surgery because of a suspected primary tumor of the renal pelvis in imaging procedures. Histology revealed the diagnosis of mesoblastic nephroma. This tumor represents a special entity of nephroblastoma that rarely occurs in adults. There is no unanimous opinion on the biological behavior of mesoblastic nephroma because the tumor behaves differently. The question of whether nephrectomy is indicated if there are no malignant features is also open. The decision depends on the given case. Nephrectomy can only be avoided if the intraoperative situation allows the tumor to be removed with an adequate distance from healthy tissue. The safety margin is necessary because mesoblastic nephroma shows fingerlike spread into the surrounding tissue.

Der gleichzeitige Nachweis der Erreger und ihres morphologischen Korrelats der Entzundung, das heist vorrangig der Leukozyturie, sichert die Diagnose. Der Begriff „Harnwegsinfektion“ bezeichnet dabei undifferenziert jede signifikante Bakteriurie von > 105 KbE/ml (CFU, „Colony forming united“; Bruhl u. Heinrich 1990). Dieser Sammelbegriff umfast das Haften, Ansiedeln und Vermehren von pathogenen und potentiell pathogenen Mikroorganismen in den harnbildenden und -ableitenden Organstrukturen sowie deren mogliche pathologische Auswirkung auf Organfunktionen. Deshalb mus der bakteriologische Befund in Zusammenhang mit Anamnese, Symptomatik, klinischem Bild und den ubrigen Harnbefunden gesehen werden. Er kann die klinische Diagnose bestatigen oder in Frage stellen.

Age dependence of activity of polymorphic N-acetyltransferase in the fetal human liver was estimated and compared with the hepatic enzyme of adults.

The methodology of the extracorporal en-bloc-perfusion of donor kidneys is described. After an application of nearly three years its advantages are explained and clearly confirmed on the basis of very good functional results after transplantation of kidneys preserved in such a way.

The influence on the specific cell-mediated immunity (CMI) of the carcinoma of the prostate gland by the contra-sexual hormone therapy with Cytonal, Estrazyt and Turisteron is controlled. For this purpose the macrophage-electrophoresis-mobility test on the basis of allogenic tumour-associated antigen of the carcinoma of the prostate gland is used. As a result the use of Cytonal at least in the dosage hitherto used is no longer worth being advocated. Turisteron and Estrazyt, respectively, taking into consideration their pharmacokinetics and indication, prove to be immunologically optimal and without hesitation, respectively. Turisteron is the basic therapeutic in the androgen-dependent carcinoma of the prostate gland. Estrazyt should be reserved to primarily and secondarily hormone-refractory tumours. For the application of Estrazyt an additive immune stimulation seems to be worth taking into consideration.

The aim of our investigations is a control of the immunocompetence of the host of the tumour during the course of the tumour disease with the help of the spontaneous rosette test (proof of the T-lymphocytes). The results hitherto got are traced back to 21 patients with adenoma of the prostate and 9 patients with carcinoma of the prostate compared with healthy persons. The methods of the test is explained. Issuing from the formation of spontaneous rosettes which is anyway decreased in patients older than 60 years up to now no clear difference could be found between patients with adenoma and carcinoma. The decrease of the formation of spontaneous rosettes is unequivocal after operation as well as in the cytonal therapy.