[Graduate education in Germany. Path out of the dead end].
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Biomedical subjects
Publications and source records attributed to H Kübler.
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The purpose of this article was to critically review the diagnostic value of positron emission tomography (PET) in urological oncology. Urinary tract tumor assessment is hampered by the renal elimination of (18)F-fluorodeoxyglucose (FDG), the most commonly used PET radiopharmaceutical. PET imaging offers no significant benefits over conventional imaging modalities for renal cell and bladder carcinomas. As a result of the low metabolic activity of prostate cancer, PET does not differentiate adequately between adenoma and carcinoma, nor detect local recurrence after radical prostatectomy with sufficient sensitivity. However, lymph node staging with FDG-PET, specifically in bladder cancer, has been shown to have a potential clinical benefit. Further studies are required to determine the clinical value of retroperitoneal lymph node staging and recurrent disease detection in germ cell tumors. Finally, encouraging early results exist for the use of serial PET measurements to predict and assess therapy response to chemotherapy which may also be valuable in urological oncology.
Operational results of a co-digestion facility were assessed over a period of 18 months. The organic fraction of municipal solid waste (OFMSW) contains a considerable amount of contaminants and grit (up to 6% w/w). A BTA-Pulper efficiently treated the different waste streams and converted a high amount of volatile solids (VS) into the digester feedstock. The seasonal fluctuations of the waste composition significantly influenced the biogas production. The impact of this seasonally variant degradability of VS had to be considered by evaluating the operation results. The waste streams investigated did not show any negative impact on digester performance. The hydraulic retention time (HRT) in the digester considerably affected the VS-reduction. Despite a considerable decrease of VS-degradation a reduction of HRT from 14 to 8 days slightly improves the gas production rate (GPR). An activated sludge system efficiently reduced the pollution of the effluent. The nutrient content of the anaerobic compost was favourable and the content of pollutants was low. The facility produced surplus electrical power up to 290 MJ/t. An overall energy balance shows that the facility substitutes primary energy.
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The present case report, which describes the transformation of a cystosarcoma phylloides into a "borderline case" and subsequently a fibrosarcoma, makes it clear that fibrosarcoma of the breast cannot always be regarded as a tumor which has developed primarily from mesenchymal breast tissue. Just as a benign cystosarcoma can turn malignant if therapy is inadequate, it can also turn into a purely sarcomatous tumor. The clinical consequences of this are that a cystosarcoma should not only be shelled out, but excised generously, with a wide border of healthy tissue. The "borderline" type of cystosarcoma phylloides, or respectively the fibrosarcoma, requires far more aggressive therapy, i.e., mastectomy. In fibrosarcoma cases additional selective lymphadenectomy may be considered, although the metastasization pattern is predominantly hematogenic. Overall, however, the prognosis for fibrosarcoma cases is better than for those with breast cancer.
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