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Diagnosis and management of testicular intraepithelial neoplasia (carcinoma in situ)--surgical aspects.

https://arctichealth.org/en/permalink/ahliterature18431
Source
APMIS. 2003 Jan;111(1):64-8; discussion 68-9
Publication Type
Article
Date
Jan-2003
Author
Klaus-Peter Dieckmann
Johannes Classen
Volker Loy
Author Affiliation
Department of Urology Albertinen-Krankenhaus Hamburg, Germany. DieckmannKP@t-online.de
Source
APMIS. 2003 Jan;111(1):64-8; discussion 68-9
Date
Jan-2003
Language
English
Publication Type
Article
Keywords
Biopsy - adverse effects - methods - statistics & numerical data
Carcinoma in Situ - pathology - radiotherapy
False Negative Reactions
Germany
Gonadal Steroid Hormones - therapeutic use
Health Surveys
Humans
Male
Postoperative Complications
Radiotherapy Dosage
Testicular Neoplasms - pathology - radiotherapy
Testis - pathology
Testosterone - therapeutic use
Abstract
Germ cell tumours (CT) are no true carcinomas; therefore the term testicular intraepithelial neoplasia (IN) is probably more appropriate than "CIS". The diagnostic accuracy of a single-site biopsy is an open question. We experienced 9 false-negative biopsies among 1859 cases. Thus, the proportion of a failed diagnosis is 0.5%. The main reason for diagnostic failure is the non-random distribution of TIN within the testicle. Currently we are investigating whether a two-site biopsy is more accurate than a single biopsy. In the ongoing trial, the over-all prevalence of TIN is around 5.3%, so far. In one quarter of the positive cases the lesion was found in only one of the two specimens. Thus, a double biopsy appears to be more favourable than the traditional single biopsy. Surgical complications amount to 2.5% in that double biopsy study. Only one surgical re-intervention was required among 983 patients. Serial imaging studies with scrotal sonography and magnetic resonance imaging (MRI) disclosed a transient intratesticular haematoma/oedema postoperatively. So, testicular biopsy, even when performed at two sites is in fact a low-complication procedure. Low dose radiotherapy to the testis is the treatment of choice for TIN. However, more than one quarter of patients require testosterone supplementation secondary to androgen-deficiency. Two dose-reduction studies (Denmark and Germany) had to be terminated prematurely because unexpected relapse of TIN was encountered at 14 Gy and 16 Gy. Possibly, hyperfragmentation schedules can overcome the antagonism of androgenic compromise and oncological safety. In a nation-wide survey, it was shown that contralateral biopsies were routinely performed in 66% of the urological departments in Germany. Another 19% offered the biopsy to particular "risk-cases"; only 15% never did a biopsy. Among those refusing biopsies, there was a higher proportion of small hospitals and a significantly lower annual case-number of GCT, when compared to those doing the biopsy. Thus, the contralateral biopsy is a well-established procedure among German urologists; those with a high caseload of GCT particularly appreciate it.
PubMed ID
12752236 View in PubMed
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[Hormonal treatment of transsexual persons].

https://arctichealth.org/en/permalink/ahliterature265696
Source
Duodecim. 2015;131(4):372-8
Publication Type
Article
Date
2015
Author
Helena Tinkanen
Pia Das
Source
Duodecim. 2015;131(4):372-8
Date
2015
Language
Finnish
Publication Type
Article
Keywords
Aging - physiology
Female
Finland
Gonadal Steroid Hormones - therapeutic use
Hormone Replacement Therapy
Humans
Male
Transsexualism - drug therapy
Abstract
The primary investigations and starting the hormonal treatment of transsexual persons takes place in Helsinki and Tampere University hospitals as part of the real life period. The hormones used are estrogen and anti-androgen for MtoF and testosterone for FtoM persons. The medication suppresses the endogenous sex-hormone production and brings about the desired features of the other sex. While the recommended doses result in physiological hormone levels, higher doses do not hasten or increase the desired changes and are a health risk. After the transition period, the follow up is referred to the person's home district. The physical and psychological status and laboratory values are evaluated at the yearly follow-up doctor visits. Although the hormone doses are lowered and percutaneous administration route is favored upon aging, stopping the medication is not recommended.
PubMed ID
26237927 View in PubMed
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[Letter: Myocardial infarct and hormone treatment in the climateric]

https://arctichealth.org/en/permalink/ahliterature56122
Source
Ugeskr Laeger. 1976 Mar 8;138(11):664-5
Publication Type
Article
Date
Mar-8-1976

Sex chromatin pattern in patients with advanced cancer breast.

https://arctichealth.org/en/permalink/ahliterature27883
Source
J Egypt Med Assoc. 1976;59(3-4):287-97
Publication Type
Article
Date
1976