Biomedical subjects
Publications and source records attributed to K C Saw.
We report a case of renal cell carcinoma that showed extensive osteosarcomatous differentiation and simulated a staghorn calculus clinically and radiologically. The literature on osteosarcomatous differentiation in renal cell carcinoma is reviewed.
OBJECTIVE: To review the outcome of orchidopexy in boys with testicular ascent. PATIENTS AND METHODS: The case notes of all the boys who underwent orchidopexy over an 18-year period, under the care of a single consultant, were collected. The reports of patients who at the initial assessment had normally descended testes and subsequently developed maldescent, were reviewed. RESULTS: At the time of the initial assessment, 69 boys (77 testes) had normally descended testes but subsequently developed maldescent. In the intervening period, 37 of these patients (38 testes) had undergone inguinal surgery for a hernia or a hydrocele (trapped testes). The remaining 34 patients had not undergone surgery and were designated as having an 'ascending testis'. The results of surgery were excellent in all but six cases. Of these, five testes failed to reach the bottom of the scrotum and one was excised. A hernial sac was found in 16 of 28 boys with a trapped testis in whom the data was recorded. CONCLUSION: Testicular ascent is uncommon and can occur spontaneously or following ipsilateral groin surgery where scarring is a likely aetiological factor. The results of surgery are usually excellent.
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The ability of patients to understand and recall information given prior to obtaining written consent was assessed in 55 patients who were due to undergo the operation of transurethral resection of prostate. The patients were also asked their opinion on informed consent. Most patients knew the position of the prostate and the purpose of the operation. Some aspects of the postoperative management and complications were less well remembered. In particular, 18% of the patients could not remember the possibility of retrograde ejaculation despite efforts to emphasize this. Of the patients who returned their questionnaires, 41% did not mind what happened to them provided they were made better; 54% trusted their doctor to do the right thing and did not think detailed explanation was important; 62% felt that consent forms are to protect the doctor's right; still most patients felt that consent forms were necessary. Sub-groups comparison showed no relationship between patients' attitude and their ability to recall information.
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A total of 1209 undescended testes in 961 boys who had no previous surgery for this problem have been reviewed with particular regard to the outcome of surgery in relation to the pre-operative and intra-operative assessment of the position of the testis. A third of impalpable testes were found at operation in the abdomen, a third in the inguinal canal and a quarter in the superficial inguinal pouch; 1% of all testes and 7% of impalpable testes were absent; 96% of all testes reached the scrotum at operation and this figure included 69% of abdominal and 94% of canalicular testes. In all 24 testes were excised--7 of which were abdominal, 8 canalicular and 9 were in the superficial inguinal pouch. The generalisation that the higher the undescended testis before operation the poorer the result, does not always hold true.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.