Clonazepam: effective treatment for restless legs syndrome in uraemia.

Orchidectomy alone for stage I testicular teratomaIt has been common practice in the United Kingdom to recommend abdominal lymph node irradiation after orchidectomy for malignant teratoma of the testis, even in the absence of demonstrable abdominal disease.We present the details of 21 men whose only treatment at the time of presentation was orchidectomy.Their subsequent survival and pattern of relapse were compared to a similar group of irradiated patients to determine the benefits of prophylactic irradiation. Patients, methods, and resultsAll patients were referred after radical orchidectomy.Clinical examination and chest radiography were the only staging procedures consistently adopted and no evidence of metastases was found.Twenty-one men seen between 1946 and 1973 received no further treatment at the time of referral.Histological specimens were reviewed at this hospital.Eighteen were malignant teratoma intermediate, two were malignant teratoma undifferentiated, and one was malignant teratoma trophoblastic.Between 1961 and 1970 100 men received postoperative lymph node irradiation.Thirty-three had malignant teratoma intermediate, 39 malignant teratoma undifferentiated, two malignant teratoma trophoblastic, two mixed teratoma and trophoblastic, and 24 mixed teratoma and seminoma.In more than two-thirds of the untreated patients radiotherapy was deferred because of recurring doubts about its efficacy.One patient was receiving peritoneal dialysis for unrelated chronic renal failure and another was severely mentally retarded.Two refused further treatment, and one was not referred until six months after orchidectomy.Fourteen patients remained alive and well.All deaths (7 of 21) occurred within two years of presentation and were due to metastatic disease.One patient died with uncontrolled para-aortic disease, six with widespread metastatic disease, and five with definite lung metastases.Analysis of deceased patients from the untreated group Time Case Age