Missed radical nephrectomy today because we had to attend pathology class at 2pm. *sigh* Should check what's on tomorrow but the OT list wasn't up yet. Shall I go and check tonight? Nahhhhh!!
Today Amira had a few chickflick moments with Dr. C. Hahaha!! You go girl!! I was wondering what's up with Dr. C today. He kept fixing up his hair every few minutes, whistling (never seen before), gave us few topics as homework too! Basically he's in a very good mood. Hah! The same thing happened with Dr. F today. He began to show us the other side of him; a kind gentleman instead of a doctor with attitude. I love the urology team. Heh.
Okay, basically let me share what were given to us as homework by Dr C. today:
1) Trans biopsy
: there are three types of trans biopsy;
- Transrectal biopsy: using ultrasound to give direction through the rectum towards the prostate, biopsy gun is being used to take samples of prostate tissues. Usually patients will undergo enema procedure which involve flushing liquid through the anal sphincter.
- Transperineal biopsy: require a small incision to be made in the perineal region (area between rectum and scrotum) to take the sample tissue.
- Transurethral biopsy: cystoscope is inserted through the urethra up to the prostatic urethral region where the tissue sample can be collected using the cutting loop.
Who need to undergo this procedure?
- men with high level of PSA (Prostate Specific Antigen) - to determine if the increasing level of PSA is due to cancer
- when digital rectal examination had detected abnormal lump in the prostate gland - to determine if there is carcinoma of the prostate
The tissue sample will be reviewed by the pathologist who will determine if the cells are cancerou cells. The cancerous cells will be assigned according to Gleason score ( 1-10 ) of which the more differentiated cells from the normal cells, the higher score will be assigned. Higher Gleason score equals to severe stage of cancer.
: basically this procedure is similar to biopsy of which tissue samples are being collected and diagnosed to determine presents of cancerous cells, infections, or any other disease. Instead of having to wait ages and ages for biopsy results, this method will give instant diagnosis of the tissue sample i.e. in about10 minutes. This method is very useful during mass surgery. During a procedure, the surgeon will take a biopsy sample from the tissue mass/organ. Pathologist will place the biopsy sample and freezes it using the cryostat machine. The frozen sample is then being sliced into thin layers using a microtomes. The layers are then stained with dyes and then it will be examined under a microscope and diagnosis can be made there and then. The advantages of using this method are:
- if the mass is determined cancerous, the surgeon can remove it instantly
- if the tissues are benign, the surgeon may not need to remove it and the surgery can end
- if more sample is needed to make more accurate diagnosis, second sample can be taken immediately without having to made second operation
- help to ensure the right tissue (cancerous) are being removed
- as been said, it's time saving procedure!
More info : here
3) Testicular Carcinoma
: this is the most popular question for final meds according to Dr. C. *hint*hint*. Okay, basically testicular cancer usually develop in men of age 15 to 35 years old. It is highly treatable due to early detection. There are a few types of testicular cancers. The most common would be the germ cell tumors which further divided to seminoma (60%) and nonseminoma (40%). Next types are stromal tumors and secondary testicular tumors.
#Germ Cell Tumor
*developed from sperm -producing germ cells of the testicle.
*two subtypes; classical seminomas
and spermatocyte seminomas
*can be differentiated by looking under the microscope
*classical seminomas has 95% occurrence in men in late 30s and early 50s
*spermatocyte seminomas is slow in growth, do not spread to other parts of body and usually diagnosed in men of average age of 55.
*tend to develop earlier in life
*men early in teen or late 40s
*subdivides into embryonal carcinomas
, yolk sac carcinomas
and teritomas#Stromal Tumor
tumor arises in supporting or hormone-producing tissues, or stroma or the testicles and subdivides to two main typesLeydig cell tumors
: tumor develop from normal Leydig cells which are important in producing androgens (e.g. testosterons) but they also produce estrogens.Sertoli cells tumors
: tumor develop in Sertoli cells which are important to protect and nourish the sperm-producing germ cells.#Secondary Testicular Tumors
Tumor in another viscera that spreads to the testicles. Lymphoma are the most common.
info from: here
Interesting isn't it?! Okay, now homework done, I can sleep peacefully...ZzzZzzZZzzz