The results of surgical treatment for cryptorchidism at Landspitalinn, 1970-1993

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Cryptorchidism is a common congenital genito-urological anomali in males with increased risk of infertility and testicular cancer. In this retrospective study the results of operations for undescended testis at Landspitalinn University Hospital were reviewed with special emphasis on patients diagnosed with testicular cancer later in life. Material and methods: The study includes 593 males with undescended testis who were operated on between 1970 and 1993. Information was gathered from hospital records, including birth-weight, age at diagnosis and operation, localization of the testes and complications to surgery. Information on patients diagnosed with testicular cancer was aquired from the Icelandic Cancer Registry. Results: The average birth-weight was 3461 g, including 58 boys (10%) with low birth-weight (Inngangur: Launeista er algengur meðfæddur galli hjá drengjum og eru helstu fylgikvillar ófrjósemi og krabbamein í eistum. Tilgangur þessarar rannsóknar var annars vegar að kanna árangur aðgerða vegna launeista og hins vegar hverjir sjúklinganna hafa greinst með krabbamein í eistum. Efniviður og aðferðir: Rannsóknin var afturvirk og náði til 593 sjúklinga sem greindust með launeista eða gengust undir launeistaaðgerð á Barnaspítala Hringsins á tímabilinu 1. janúar 1970 til 31. desember 1993. Upplýsingar fengust úr sjúkraskrám, meðal annars um fæðingarþyngd, aldur við greiningu og aðgerð, staðsetningu eistans og fylgikvilla við aðgerðina. Með upplýsingum úr krabbameinsskrá Krabbameinsfélags Íslands var athugað hverjir þessara sjúklinga höfðu greinst með eistnakrabbamein fram til 31. desember 2000. Niðurstöður: Meðalfæðingarþyngd var 3461 g, þar af 58 drengir (10%) með fæðingarþyngd 2500 g. Meðalaldur við greiningu var 3,0 ár (bil 0-14 ár) og við aðgerð 7,5 ár (bil 0-51 ár). Launeista var algengara hægra megin (61%) (p<0,01) en 18% drengjanna voru með launeista beggja vegna. Við aðgerð var eistað í náragangi í 50% tilvika, í kviðarholi hjá 10% sjúklinga og í 34% tilvika utan leiðar (ectopic). Fylgikvillar sáust eftir 29 aðgerðir (5%) þar sem blóðgúll (2,7%) og skurðsýking (1,2%) voru algengastar. Rúmur helmingur (52%) drengjanna reyndist einnig hafa nárakviðslit. Af þessum 593 sjúklingum hafa tveir greinst með krabbamein í eistum, báðir með fósturvísiskrabbamein, 13 og 14 árum eftir launeistaaðgerð. Ályktanir: Árangur launeistaaðgerða er góður í þessari rannsókn. Greiningaraldur er tiltölulega hár (3,0 ár) en fer lækkandi. Aðgerðaraldur er sömuleiðis hár (7,5 ár) og töf á meðferð (4,5 ár) er óþarflega löng. Í þessari rannsókn var hlutfall þeirra sem greindust með eistnakrabbamein mjög lágt, eða 0,3%. Upplýsingar um ófrjósemi liggja ekki fyrir í þessari rannsókn

Ontology and medical terminology: Why description logics are not enough

Ontology is currently perceived as the solution of first resort for all problems related to biomedical terminology, and the use of description logics is seen as a minimal requirement on adequate ontology-based systems. Contrary to common conceptions, however, description logics alone are not able to prevent incorrect representations; this is because they do not come with a theory indicating what is computed by using them, just as classical arithmetic does not tell us anything about the entities that are added or subtracted. In this paper we shall show that ontology is indeed an essential part of any solution to the problems of medical terminology – but only if it is understood in the right sort of way. Ontological engineering, we shall argue, should in every case go hand in hand with a sound ontological theory

Cancer Epidemiol Biomarkers Prev

BackgroundTesticular germ cell tumor (TGCT) incidence has increased over the last 40 years in the United States. In contrast to TGCT among infants, it is hypothesized that TGCT in adolescents and young men is the result of sex steroid hormone imbalance during early fetal development. However, little is known about the neonatal period when abrupt hormonal changes occur, and direct supporting evidence is scarce due to the difficulties in obtaining pre-diagnostic specimens.MethodsWe conducted a population-based case-control study examining hormone levels at birth among 91 infants (0\u20134 years) and 276 adolescents (15\u201319 years) diagnosed with TGCT, and 344 matched controls. Estrogen and androgen levels were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS) from archived newborn dried blood spots. Logistic regression models were used to estimate the association between each hormone level and TGCT risk.ResultsHigher levels of androstenedione were associated with increased TGCT risk among adolescents (OR: 2.33, 95% CI: 1.37\u20133.97 for highest vs. lowest quartile; p-trend=0.003) but not among infants (OR: 0.70, 95% CI: 0.28\u20131.77). A similar pattern was observed for testosterone (OR: 1.73, 95% CI: 1.00\u20133.00,) although the trend was not significant (p-trend=0.12). Associations were stronger among non-Hispanic white subjects, relative to Hispanics. There was no difference by tumor histologic subtype. Estriol (the only detectable estrogen) was not associated with TGCT risk in either age group.ConclusionsHigher levels of neonatal androgens were associated with increased risk of TGCT among adolescents, suggesting that early life hormone levels are related to the later development of TGCT.HHSN261201000140C/CA/NCI NIH HHS/United StatesHHSN261201000035C/CA/NCI NIH HHS/United StatesUL1 TR001863/TR/NCATS NIH HHS/United StatesHHSN261201000035I/CA/NCI NIH HHS/United StatesHHSN261201000034C/CA/NCI NIH HHS/United StatesU58 DP003862/DP/NCCDPHP CDC HHS/United StatesR21 CA185725/CA/NCI NIH HHS/United States2019-04-01T00:00:00Z29475970PMC58847186095vault:2775

Triorchidism: genetic and imaging evaluation in an adult male

We report the results of imaging and cytogenetic studies in a case of tri- orchidism in a 54 years old male without any associated anomaly. A scrotal ultrasonography revealed the presence of two testes within the left hemiscrotum with complete septa- tion and echotexture and vascular flow pattern similar to the vascular flow of the normal right testis. There was no focal abnormal echogenicity suggesting malignancy. Scrotal MRI confirmed two soft-tissue structures in the left hemiscrotum with normal signal intensity at T1w and T2w images. Both testes had a tunica albuginea with low-signal intensity. Cytogenetic analysis resulted in normal male karyotype 46XY. Array-CGH analysis detected the presence of two interstitial rearrangements: a ~120 Kb deletion of chro- mosome 1 and a ~140 Kb deletion of chromosome 16. Currently there are little details on the functions of both genes

Bilateral spermatic cord en bloc ligation by laparoendoscopic single-site surgery: preliminary experience compared to conventional laparoscopy

BACKGROUND: Laparo Endoscopic Single-site Surgery (LESS) represents an evolution of minimally invasive surgery and aims to improve cosmetic outcome and reduce surgical trauma and complications associated with traditional laparoscopy. This study was performed to present our preliminary experience in bilateral spermatic cord ligation with the LESS technique and compare the results with the outcomes of conventional laparoscopic surgery. METHODS: Between June 2007 and May 2013, 24 patients were referred to our institute for bilateral varicocelectomy. The indications for this type of procedure were bilateral varicocele with impairment of semen parameters or chronic bilateral testicular pain. All procedures were performed via the same surgeon. The patients were divided into two groups according to the type of laparoscopic surgery. Group A included 10 patients underwent LESS technique while group B included the remaining 14 patients that underwent conventional laparoscopy. RESULTS: The comparison between the two techniques showed some important advantages for LESS: shorter operating time (45.4 min vs. 88.3 (P\u2009<\u2009.001), shorter hospital stay (16.6 hours vs. 51.4 hours) (P\u2009<\u2009.001), early return to the normal activity (2.3 days vs. 4.7 days) and better cosmetic outcomes. No conversions from LESS to conventional laparoscopy were necessary and blood loss was insignificant in all patients.All patients in the LESS group reported full satisfaction with the cosmetic outcome, whereas 85.7% of patients after conventional laparoscopy were fully satisfied with cosmesis. CONCLUSIONS: Bilateral spermatic cord ligation with LESS is an alternative to conventional laparoscopy. The procedure was successfully performed in all patients. The trans-umbilical approach offers the advantage of a better cosmetic result, shorter hospital stay and less postoperative pain

An Evolution of Orchiopexy: Historical Aspect

The history of treatment for cryptorchidism dates back more than 200 years. This review is intended to highlight some historical aspect that led us to our current surgical treatment of this condition. The medical and historical surgical literatures pertaining to cryptorchidism were reviewed. Data sources were PubMed, Embase, conference proceedings, and bibliographies. No language, date, or publication status restrictions were imposed. The study of cryptorchidism began with the anatomical descriptions of Baron Albrecht von Haller and John Hunter. Attempts at surgical correction of the undescended testis began in the early 1800s, culminating in the first successful orchiopexy by Thomas Annandale in 1877. Max Schüller, Arthur Dean Bevan and Lattimer contributed to the establishment of current techniques for standard orchiopexy. Later, laparoscopy, high inguinal incision (Jones' approach) and scrotal approach were added to the list of current orchiopexy

Torsion of Testis in an Infant with Unilateral UDT

Torsion of an undescended testis is uncommon. Torsion of a cryptorchid testicle presents a nonspecific symptomatology. Clinical suspicion indicates emergent surgical exploration, irrespective of Doppler ultrasound with its inherent false negative results. Management of the contralateral testis is controversial. We emphasize the need of a complete physical examination of the child who goes to the emergency room with nonspecific symptoms of abdominal pain and ipsilateral empty hemiscrotum to rule out torsion of a cryptorchid testicle. Herein, we report a one-year-old infant with missed torsion of undescended left testis