[Paratesticular mesothelioma]. / Paratestikuläres Mesotheliom.

Paratesticular mesothelioma is a very rare entity of this aggressive malignancy. In 30-40 % of all cases an exposition to asbestos exists in the anamnesis. We report on a typical case of paratesticular mesothelioma in a roof slater and tiler who had had occupational contact with asbestos-containing materials over decades. The recommended diagnostics and therapy are discussed and the importance of the identification as an occupational disease is emphasized.

[Quality of care in patients with newly diagnosed bladder cancer: a prospective assessment in northern Germany]. / Versorgungsstandard bei neu diagnostiziertem Blasenkarzinom : Eine prospektive Erhebung in Norddeutschland.

INTRODUCTION: The aim of this study was to evaluate the current quality of care in newly diagnosed bladder cancer patients in a regional representative sample of German urologists. MATERIAL AND METHODS: Using a standardized questionnaire clinical and pathological data from over 400 patients with newly diagnosed urothelial carcinoma of the bladder (UCB) between January and December 2010 were collected from urology health care practitioners in northern Germany. As diagnostic and therapeutic decisions were not influenced by a specific protocol these findings represent current regional practice patterns. RESULTS: Complete data of 359 patients were available for analysis. The median patient age at diagnosis was 72 years (range 29-98 years) with a male:female ratio of 3:1. The main reasons for transurethral resection of the bladder (TURB) were microhematuria (45.4 %), conspicuous ultrasound findings (12.8 %) and gross hematuria (11.7 %). Using photodynamic diagnosis (PDD) TURB was performed in 78 patients (21.7 %). The results of histopathology showed papillary urothelial neoplasm of low malignant potential (PUNLMP) in 8 patients (2.2 %), pTa in 202 (56.3 %), pTis in 7 (1.9 %), pT1 in 88 (24.5 %) and ≥pT2 bladder cancer in 54 (15 %) patients. Multiple tumors were recorded in 107 patients (29.8 %). A repeat TURB was performed in 130 patients (36.8 %) in a median of 45 days and residual tumor tissue was found in 79 of these patients (60.8 %). Immediate postoperative instillation chemotherapy was performed in 152 patients (42.3 %) and adjuvant intravesical maintenance therapy was performed in 142 patients (39.6 %, mitomycin 29.2 % vs. BCG 10.4 %). Patients treated with repeat TURB or adjuvant instillation therapy were more likely to have higher tumor stages and grades (p-values< 0.001). Overall 25 patients (7.7 %) experienced disease recurrence within 3 months. Lower tumor stage and grade, performance of repeat TURB and administration of adjuvant intravesical therapy were associated with reduced early disease recurrence (p-values ≤ 0.009). CONCLUSIONS: The current study presents contemporary findings and practice patterns in patients with newly diagnosed bladder cancer. Interestingly, the rates of immediate postoperative instillation chemotherapy and maintenance intravesical therapy were lower than expected. Utilization of PDD-TURB is still underrepresented. Remarkable is the high number of patients with residual tumor in the repeat TURB. Differences in patient counselling, hospital practice standards and compliance factors most likely contribute to variations in guideline adherence.

Field aging of insecticides after repeated application to a northern Thailand ultisol.

Field aging immobilizes pollutants and reduces their toxicity, but it also boosts their accumulation and holds the risk of future release. We investigated the aging of six insecticides (water solubilities: 0.33 mg L (-1)-completely miscible) applied five times (10-day intervals) to a tropical fruit orchard under natural weather conditions. After sequential extractions of soil samples with 0.01 M CaCl 2, methanol (MeOH), and acetone/ethylacetate/water (AEW), a conventional ( K OC(app) = [ c(MeOH) + c(AEW)]/ c(CaCl 2), normalized to soil organic carbon) and a newly introduced distribution ratio (MAR = MeOH/AEW ratio; c(MeOH)/ c(AEW)) were calculated. Field half-lives of the insecticides correlated with K OC(app) but not with MAR, which might reflect that dissipation was significantly affected by abiotic processes. The extent of aging was related to hydrophobicity of the compounds and most pronounced for endosulfan (3-fold increase in K OC(app) within 84 days). For dimethoate, this increase was even steeper (5- to 10-fold within 10 days), which was, however, mostly caused by dissipation from labile pools rather than by aging. The K OC(app) of chlorpyrifos remained constant, but a significant decrease in MAR ( r = -0.78) revealed that sorption strength increased nevertheless. Results for malathion were ambiguous. Within the time frame of our study, neither K OC(app) nor MAR gave evidence for the aging of mevinphos. The different dynamics of K OC(app) and MAR for the six insecticides studied indicate that different aging mechanisms or rates, or both control the fate of the individual insecticides, which can potentially be revealed by sequential exctraction procedures.