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[PMID]: 29391177
[Au] Autor:Powers R; Hurley S; Park E; McArdle B; Vidal P; Psutka SP; Hollowell CMP
[Ad] Address:Division of Urology, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois. Electronic address: rpowers@cookcountyhhs.org.
[Ti] Title:Usefulness of Preoperative Ultrasound for the Evaluation of Testicular Rupture in the Setting of Scrotal Gunshot Wounds.
[So] Source:J Urol;, 2018 Jan 31.
[Is] ISSN:1527-3792
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: A scrotal gunshot wound may result in testicular injury, necessitating urgent scrotal exploration and attempted testicular salvage. Scrotal ultrasound is highly sensitive and specific for testicular rupture in the setting of blunt scrotal trauma but it has been poorly studied in the setting of scrotal gunshot wounds. Our objective was to determine the accuracy of scrotal ultrasound to identify testicular rupture following a scrotal gunshot wound. MATERIALS AND METHODS: We retrospectively reviewed the records of patients with a scrotal gunshot wound from 2003 to 2014 in whom preoperative ultrasound was done prior to scrotal exploration. A heterogeneous echo pattern of testicular parenchyma with contour loss was considered a positive examination for testicular rupture. Patients underwent scrotal exploration within 24 hours of presentation. The sensitivity and specificity of ultrasound were estimated and compared to operative findings. ROC curve analysis was done. RESULTS: Of 75 patients who sustained a scrotal gunshot wound ultrasound was positive in 30 and negative in 45. No ultrasound revealed bilateral injuries. Scrotal exploration demonstrated a total of 40 testicular ruptures in 35 patients, of which 30 testicles were salvaged. Ten orchiectomies were performed. The sensitivity and specificity of ultrasound were 60% and 95%, respectively, with 16 missed injuries and 6 false-positive findings. Positive predictive value was 80% and negative predictive value was 87%. The ROC AUC was 0.79. In 6 of the 16 missed injuries there was an ipsilateral hematocele or hematoma. CONCLUSIONS: The sensitivity of scrotal ultrasound is limited for evaluating testicular rupture after a scrotal gunshot wound. Large coincident hematoceles or hematomas may obscure the diagnosis of testicular rupture. Negative ultrasound should not preclude scrotal exploration after a scrotal gunshot wound is sustained.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180310
[Lr] Last revision date:180310
[St] Status:Publisher

  2 / 206 MEDLINE  
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[PMID]: 29258479
[Au] Autor:Staubitz JI; Gassmann P; Kauff DW; Lang H
[Ad] Address:Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany.
[Ti] Title:Surgical treatment strategies for giant inguinoscrotal hernia - a case report with review of the literature.
[So] Source:BMC Surg;17(1):135, 2017 Dec 19.
[Is] ISSN:1471-2482
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: An inguinoscrotal hernia is defined as "giant" if descending below the midpoint of the inner thigh of a patient in upright position. In developed countries this is a rare entity. In the literature different surgical techniques have been reported so far to achieve a successful treatment. CASE PRESENTATION: We present the case of a 63 year-old man suffering from a giant inguinoscrotal hernia, whom we treated using a combined open transabdominal and inguinal approach following an unsuccessful laparoscopic attempt. Meshes were placed in a premuscular position (Lichtenstein's procedure) and in a preperitoneal position. In addition, a reconstruction of the abdominal wall by modified components separation technique was performed. During the early postoperative period no complications were registered. Intensive care treatment was not necessary. The patient was discharged on postoperative day 8 in an excellent condition. Six months after surgery a scrotal hematocele was diagnosed and operatively removed. After a follow-up of 1.5 years neither hernia recurrence, nor chronic groin pain were recorded. The patient reported to be sexually active. His quality of life improved notably. Additionally, a Medline and PubMed database research was performed to create an overall picture of the existing surgical treatment strategies. Included were patients with diagnosis of primary giant inguinoscrotal hernia according to the given definition. Emergency interventions and cases without details of the surgical approach were excluded. CONCLUSIONS: Firstly, this report describes a novel, successful surgical treatment of a giant inguinoscrotal hernia without administering preoperative progressive pneumoperitoneum therapy or visceral resection. Secondly, we summarize cases previously reported as a practical guide for possible surgical therapy approaches.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 171222
[Lr] Last revision date:171222
[St] Status:In-Process
[do] DOI:10.1186/s12893-017-0331-x

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[PMID]: 28405707
[Au] Autor:Lyttwin B; Moltzahn F; Thalmann GN
[Ad] Address:Urologische Universitätsklinik, Anna-Seiler-Haus, Inselspital Bern, Freiburgstraße 10, 3010, Bern, Schweiz.
[Ti] Title:Therapiemanagement des stumpfen Hodentraumas. [Therapeutic management of blunt testicular trauma].
[So] Source:Urologe A;56(7):864-867, 2017 Jul.
[Is] ISSN:1433-0563
[Cp] Country of publication:Germany
[La] Language:ger
[Ab] Abstract:Testicular trauma is a rare emergency. While penetrating injuries need surgical revision, blunt injuries may be treated conservatively. However, in case of testicular rupture early surgical intervention increases the chance of testicular preservation. Therefore, a meticulous urological diagnosis is important to avoid complications and to reduce rates of secondary orchiectomy.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1704
[Cu] Class update date: 170718
[Lr] Last revision date:170718
[St] Status:In-Process
[do] DOI:10.1007/s00120-017-0383-7

  4 / 206 MEDLINE  
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[PMID]: 27178275
[Au] Autor:Niwa N; Yoshida T; Mizuno R
[Ad] Address:Department of Urology, School of Medicine, Keio University, Tokyo, Japan.
[Ti] Title:Idiopathic hematocele in a patient receiving peritoneal dialysis.
[So] Source:Clin Exp Nephrol;21(2):350-351, 2017 Apr.
[Is] ISSN:1437-7799
[Cp] Country of publication:Japan
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1605
[Cu] Class update date: 170412
[Lr] Last revision date:170412
[St] Status:In-Data-Review
[do] DOI:10.1007/s10157-016-1279-3

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[PMID]: 27163438
[Au] Autor:Nistal M; Paniagua R; González-Peramato P; Reyes-Múgica M
[Ad] Address:1 Department of Pathology, Hospital La Paz, Universidad Autónoma de Madrid, Madrid 28029, Spain.
[Ti] Title:Perspectives in Pediatric Pathology, Chapter 23. Testicular Pathology Secondary to Physical and Chemical Injury.
[So] Source:Pediatr Dev Pathol;19(6):452-459, 2016 Nov/Dec.
[Is] ISSN:1093-5266
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Testicles can be damaged by a variety of physical and chemical agents, ranging from trauma suffered in accidents or athletic activities, to diverse drugs or radiation used in cancer treatment. The immediate and long-term effects of these damaging agents at the testicular morphologic and functional levels are quite varied and may have significant impact on the fertility of the pediatric patient once reproductive age is reached.
[Mh] MeSH terms primary: Testicular Diseases/chemically induced
Testis/injuries
Testis/pathology
[Mh] MeSH terms secundary: Child, Preschool
Humans
Male
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1706
[Cu] Class update date: 170619
[Lr] Last revision date:170619
[Js] Journal subset:IM
[Da] Date of entry for processing:160511
[St] Status:MEDLINE
[do] DOI:10.2350/16-04-1811-PB.1

  6 / 206 MEDLINE  
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[PMID]: 27112160
[Au] Autor:Fenton LZ; Karakas SP; Baskin L; Campbell JB
[Ad] Address:Department of Pediatric Radiology, Children's Hospital Colorado, affiliated with the University of Colorado School of Medicine, 13123 East 16th Ave., B125, Aurora, CO, 80045, USA. Laura.Fenton@childrenscolorado.org.
[Ti] Title:Sonography of pediatric blunt scrotal trauma: what the pediatric urologist wants to know.
[So] Source:Pediatr Radiol;46(7):1049-58, 2016 Jun.
[Is] ISSN:1432-1998
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Pediatric blunt scrotal trauma is most often the consequence of sports injury and presents a diagnostic challenge because swelling and pain make a scrotal physical exam difficult. US with color flow and duplex Doppler is the first-line imaging modality with the goal of accurate and timely diagnosis of injury requiring surgery to preserve fertility and hormonal function. US imaging findings following blunt scrotal trauma include hydrocele, hematocele, testicular hematoma, testicular fracture, testicular rupture, compromised perfusion/testicular torsion and testicular dislocation. Importantly, several of these findings may coexist. Our goal is to present the pertinent intrascrotal anatomy, US imaging findings for each testicular injury, and contemporary management for each, with emphasis on what our pediatric urology colleagues need to know for optimal patient care.
[Mh] MeSH terms primary: Scrotum/diagnostic imaging
Scrotum/injuries
Ultrasonography/methods
Wounds, Nonpenetrating/diagnostic imaging
[Mh] MeSH terms secundary: Athletic Injuries/diagnostic imaging
Child
Humans
Male
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1709
[Cu] Class update date: 170922
[Lr] Last revision date:170922
[Js] Journal subset:IM
[Da] Date of entry for processing:160427
[St] Status:MEDLINE
[do] DOI:10.1007/s00247-016-3600-4

  7 / 206 MEDLINE  
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[PMID]: 26850173
[Au] Autor:Deng ZL; Chu L; Chen L; Yang JS
[Ad] Address:Department of Orthopaedics, The Second Affiliated Hospital, Chongqing Medical University, No. 76 Linjiang Road, District Yuzhong, Chongqing, 400010, China. Electronic address: zhongliang.deng@yahoo.com.
[Ti] Title:Anterior transcorporeal approach of percutaneous endoscopic cervical discectomy for disc herniation at the C4-C5 levels: a technical note.
[So] Source:Spine J;16(5):659-66, 2016 05.
[Is] ISSN:1878-1632
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND CONTEXT: With the continuous development of the spinal endoscopic technique in recent years, percutaneous endoscopic cervical discectomy (PECD) has emerged, which bridges the gap between conservative therapy and traditional surgery and has been mainly divided into the anterior transdiscal approach and the posterior interlaminar access. Because of the relatively greater violation to the anterior nucleus pulposus, there is a higher potential of postoperative intervertebral space decrease in the anterior transdiscal approach than in the posterior interlaminar access. In addition, when the herniated lesion is migrated upward or downward behind the vertebral body, both approaches, and even anterior cervical discectomy and fusion, are impractical, and corpectomy is commonly considered as the only efficacious treatment. Anterior transcorporeal approach under endoscopy could enable an individual and adjustable trajectory within the vertebral body under different conditions of disc herniation preserving the motion of adjacent segment, especially in a migrated or sequestered lesion. PURPOSE: This report aimed to first describe a novel anterior transcorporeal approach under endoscopy in which we addressed a migrated disc herniation at the C4-C5 levels. STUDY DESIGN: A technical report was carried out. PATIENT SAMPLE: A 37-year-old woman presented with posterior neck pain and weakness of extremities for 9 months. On neurologic examination, tingling sensation and numbness were not obvious. However, the power of extremities was dramatically decreased at a level of 3. Hoffmann sign was positive in the bilateral hand. Magnetic resonance imaging (MRI) showed a huge herniation of the C4-C5 disc compressing the median area of the spinal cord. Besides the C4-C5 disc herniation, preoperative computer tomography (CT) also detected that the herniated disc had partial calcification. A novel anterior transcorporeal approach of PECD, through the vertebral body of C5, was performed to address a migrated disc herniation at the C4-C5 levels. OUTCOME MEASURES: The posterior neck pain was measured using the visual analog scale (VAS). METHODS: A novel anterior transcorporeal approach under endoscopy was performed to address a migrated disc herniation at the C4-C5 levels. RESULTS: This operation was accomplished in 75 minutes. Postoperatively, the drainage tube was retained into the drilling hole for 24 hours to avoid the possibility of hematoma. The patient was advised to wear a neck collar for 3 weeks. Immediately after the operation, the posterior neck pain improved from VAS 7/10 preoperatively to 3/10, and the myodynamia of extremities improved stepwise. At 12 hours postoperatively, the range of motion was also improved. In the further follow-up, the patient has completely recovered from the preoperative symptoms, whose myodynamia of extremities is normal. Besides the postoperative MRI, a total removal of the herniated disc and the transcorporeal drilling tunnel are observed in CT. At postoperative 3-month follow-up, neither disc space narrowing nor instability was observed on CT, in which the bone defect after drilling tunnelwas partially decreased, indicating bone healing. There were no surgery-related complications, such as dysphagia, Horner syndrome, recurrent laryngeal nerve palsy, vagus nerve injury, tracheoesophageal injury, or cervical hematocele. CONCLUSIONS: As a supplement to the described surgical approach of PECD, the transcorporeal approach is a novel access for the treatment of cervical intervertebral disc herniation. Among the advantages of this approach are providing a clear visual field during microendoscopic surgery and decreasing the intraoperative iatrogenic injury to, as well as avoiding violation to the discal tissue. Theoretically, the potential of secondary decline of intervertebral height is low. However, as the limitation of one case shows, whether this transcorporeal approach is efficacious and reliable should be verified in a further comparative cohort study with a large volume of patients.
[Mh] MeSH terms primary: Diskectomy, Percutaneous/methods
Intervertebral Disc Displacement/surgery
Surgery, Computer-Assisted/methods
[Mh] MeSH terms secundary: Adult
Cohort Studies
Diskectomy, Percutaneous/adverse effects
Endoscopy/methods
Female
Humans
Intervertebral Disc Displacement/diagnostic imaging
Magnetic Resonance Imaging
Male
Middle Aged
Neck Pain/etiology
Postoperative Complications
Surgery, Computer-Assisted/adverse effects
Tomography, X-Ray Computed
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1705
[Cu] Class update date: 170504
[Lr] Last revision date:170504
[Js] Journal subset:IM
[Da] Date of entry for processing:160207
[St] Status:MEDLINE

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[PMID]: 26766321
[Au] Autor:Wen F; Dong Y; Lu ZM; Liu ZY; Li W; Guo QY
[Ad] Address:*Department of Radiology, Shengjing Hospital, China Medical University, Shenyang †Department of Radiology, LiaoNing Cancer Hospital, DaLian Medical University Clinical Oncology College, Shenyang, Liaoning, China.
[Ti] Title:Hemobilia After Laparoscopic Cholecystectomy: Imaging Features and Management of an Unusual Complication.
[So] Source:Surg Laparosc Endosc Percutan Tech;26(1):e18-24, 2016 Feb.
[Is] ISSN:1534-4908
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: To assess the imaging features and the management of hemobilia after laparoscopic cholecystectomy (LC). MATERIALS AND METHODS: A total of 12 patients who were treated for hemobilia after LC were included in the study. Selective arteriography was performed to find the bleeding artery. Coils or microcoils were deployed superselectively to occlude the bleeding branch. The clinical course, imaging findings, the embolic effect, complications, and follow-up were evaluated. RESULTS: Risk factors for hemobilia included a variant ductal anatomy, a variant cystic artery, and intraoperative adhesion. Abdominal computed tomography (CT) could provide the diagnostic signs as follows: a hematocele in the abdominal cavity, the gallbladder fossa, and the bile duct, biliary dilation, pseudoaneurysm of the right hepatic artery, and contrast extravasations on contrast-enhanced CT. No rebleeding occurred after the transcatheter arterial embolization in all patients without immediate procedural complications. CONCLUSIONS: Gallbladder triangle anatomic variation and intraoperative adhesion were the risk factors for hemobilia after LC. Abdominal CT is a useful examination for the diagnosis. Transcatheter arterial embolization is the therapeutic option of choice.
[Mh] MeSH terms primary: Cholecystectomy, Laparoscopic/adverse effects
Embolization, Therapeutic/methods
Hemobilia/etiology
[Mh] MeSH terms secundary: Adult
Aged
Female
Follow-Up Studies
Hemobilia/diagnostic imaging
Hemobilia/therapy
Hepatic Artery/diagnostic imaging
Humans
Male
Middle Aged
Postoperative Complications/etiology
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1610
[Cu] Class update date: 170103
[Lr] Last revision date:170103
[Js] Journal subset:IM
[Da] Date of entry for processing:160115
[St] Status:MEDLINE
[do] DOI:10.1097/SLE.0000000000000241

  9 / 206 MEDLINE  
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[PMID]: 26745515
[Au] Autor:Tian W; Zhang J; Chen J; Liu Y; Chen X; Wang N
[Ad] Address:Department of Radiology, Taizhou People's Hospital, Taizhou 225300, Jiangsu Province, China.
[Ti] Title:A quantitative study of intracranial hypotensive syndrome by magnetic resonance.
[So] Source:Clin Neurol Neurosurg;141:71-6, 2016 Feb.
[Is] ISSN:1872-6968
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: The study aims to investigate the magnetic resonance imaging (MRI) findings of intracranial hypotension syndrome (IHS) and the change of quantitative indicators, so as to yield a deeper understanding of the disease. PATIENTS AND METHODS: The clinical data and MRI findings of 26 cases of IHS which were confirmed by lumbar puncture were retrospectively analyzed. Two physicians evaluated the MRI findings including thickening and enhancement of dural, pituitary enlargement, subdural effusion (hematocele), venous engorgement and brain sagging, and measured the quantitative indicators including mamillopontine distance and pontomesencephalic angle. The consistency between the two results of the physicians was assessed by Kappa consistency test. The differences of mamillopontine distance and pontomesencephalic angle between the patient group and the control group were determined by paired t-test. The diagnostic efficiency of mamillopontine distance and pontomesencephalic angle was assessed by area under the ROC curve, and their best diagnostic thresholds were also determined, respectively. Age- and sex-matched healthy volunteers controls (n=26) were recruited and served as the control group. RESULTS: All of the 26 patients suffered from the characterized by orthostatic headache of IHS. The clinical evaluations of dural thickening and enhancement, pituitary enlargement, subdural effusion (hematocele), venous engorgement by the two physicians showed excellent agreements (κ=0.808, 1 and 0.906, P<0.01), and the clinical evaluations of brain sagging showed medium agreements (κ=0.606, P<0.01). The mamillopontine distance and pontomesencephalic angle of the patient group were 5.4 ± 1.6mm and 47.8 ± 8.7°, respectively, which were obviously less than those of the control group (6.9 ± 1.1mm and 61.0 ± 6.1°, respectively), and the differences were statistically significant (t=-4.563, P<0.01; t=-.329, P<0.01). The area under ROC curve of mamillopontine distance and pontomesencephalic angle were 0.774 and 0.908, respectively, and the diagnostic value of pontomesencephalic angle was higher than that of the mamillopontine distance. The sensitivity and specificity were 73.1% and 73.1%, respectively, when diagnostic threshold of mamillopontine distance was 6.4mm. The sensitivity and specificity were 76.9% and 96.2%, when diagnostic threshold of pontomesencephalic angle was 51.7°. CONCLUSION: The MRI findings presented characteristic features of IHS. The quantitative indicators including mamillopontine distance and pontomesencephalic angle were helpful for clinical diagnosis of subjective findings of IHS.
[Mh] MeSH terms primary: Headache/diagnosis
Intracranial Hypotension/diagnosis
Magnetic Resonance Imaging/methods
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Double-Blind Method
Female
Headache/complications
Humans
Intracranial Hypotension/complications
Male
Mammillary Bodies/pathology
Mesencephalon/pathology
Middle Aged
Pontine Tegmentum/pathology
Retrospective Studies
Syndrome
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Entry month:1610
[Cu] Class update date: 161230
[Lr] Last revision date:161230
[Js] Journal subset:IM
[Da] Date of entry for processing:160109
[St] Status:MEDLINE

  10 / 206 MEDLINE  
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[PMID]: 28058365
[Au] Autor:Ayvaz OD; Celayir AC; Moralioglu S; Bosnali O; Pektas OZ; Pelin AK; Caman S
[Ad] Address:Department of Pediatric Surgery, Zeynep Kamil Obstetrics and Children's Training and Research Hospital, Istanbul, Turkey.
[Ti] Title:Four-year retrospective look for acute scrotal pathologies.
[So] Source:North Clin Istanb;2(3):182-188, 2015.
[Is] ISSN:2536-4553
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:OBJECTIVE: A group of diseases in the scrotum setting forth by the sudden swelling and redness and pain consist of acute scrotal pathologies. The most common causes of acute scrotum in children are epididymitis, epididymo-orchitis, orchitis, testicular torsion, torsion of the appendix testis, incarcerated inguinal hernia and traumatic hydro/hematocele. In this study; we aim to evaulate patients with acute scrotal pathologies who were interned in our department. METHODS: All hospital data of cases who were interned at our deparment due to acute scrotum in between June 2010-June 2014 were evaluated retrospectively. Cases with incarcerated inguinal herni were excluded in this study. RESULTS: In a 4-year-period 114 cases were interned in our department with acute scrotum. Mean age of the patients was 7.6±4.577 years (min: 1m-max: 18yrs). Doppler US was performed in 112 patients to evaluate the blood flow while in 2 patients applied after normal office hours were evaluated without Doppler US and operated under emergency conditions. The patients had received diagnosis of epididymitis/epididymo-orchitis/orchitis (n=83 cases; 72.8%), testicular torsion (n=24; 21.1%), torsion of the appendix testis (n=2; 1.8%) with and traumatic hydrocele/ hematocele (n=5; 4.4%). While detorsion was performed in 18 (75%) cases with testicular torsion and orchiectomy in 6 (25%) cases. Histopathological evaluation of orchiectomy specimens revealed hemorrhagic necrosis and hemorrhagic infarction or ischemic changes. Normal testicular size and vascularity were detected in 11 (61.1%) cases with detorsioned testis as detected by follow-up Doppler US. Late orchiectomy was performed in 7 cases (38.9%) with complete atrophy due to lack of blood supply. CONCLUSION: Although Doppler US is very helpful for differential diagnosis of patients with acute scrotum who applied early period, if Doppler US will lead to a waste of time, direct surgery without delay will reduce the risk of testicular loss.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1701
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.14744/nci.2016.16768


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