A Case of Renal Angiomyolipoma with Minimal Fat Mimicking Renal Cell Carcinoma

We present a case of renal angiomyolipoma (AML) with minimal fat mimicking renal cell carcinoma(RCC). AML is composed of variable amount of fat, smooth muscle and abnormal blood vessels. In general,AML can be differentiated from RCC with great accuracy using modern radiological techniques due to thefat component of the renal mass. In the present case, the renal tumor did not demonstrate intratumoral faton radiological studies. Surgery was performed and the renal tumor was removed. Histologically, the renaltumor showed abundant muscle that occupied almost the entire lesion, which demonstrated HMB-45 antigen.The tumor was diagnosed as renal AML

Single minimum incision endoscopic radical nephrectomy for renal tumors with preoperative virtual navigation using 3D-CT volume-rendering

<p>Abstract</p> <p>Background</p> <p>Single minimum incision endoscopic surgery (MIES) involves the use of a flexible high-definition laparoscope to facilitate open surgery. We reviewed our method of radical nephrectomy for renal tumors, which is single MIES combined with preoperative virtual surgery employing three-dimensional CT images reconstructed by the volume rendering method (3D-CT images) in order to safely and appropriately approach the renal hilar vessels. We also assessed the usefulness of 3D-CT images.</p> <p>Methods</p> <p>Radical nephrectomy was done by single MIES via the translumbar approach in 80 consecutive patients. We performed the initial 20 MIES nephrectomies without preoperative 3D-CT images and the subsequent 60 MIES nephrectomies with preoperative 3D-CT images for evaluation of the renal hilar vessels and the relation of each tumor to the surrounding structures. On the basis of the 3D information, preoperative virtual surgery was performed with a computer.</p> <p>Results</p> <p>Single MIES nephrectomy was successful in all patients. In the 60 patients who underwent 3D-CT, the number of renal arteries and veins corresponded exactly with the preoperative 3D-CT data (100% sensitivity and 100% specificity). These 60 nephrectomies were completed with a shorter operating time and smaller blood loss than the initial 20 nephrectomies.</p> <p>Conclusions</p> <p>Single MIES radical nephrectomy combined with 3D-CT and virtual surgery achieved a shorter operating time and less blood loss, possibly due to safer and easier handling of the renal hilar vessels.</p

A Case of Cystic Renal Cell Carcinoma Mimicking a Benign Complicated Renal Cyst on Computed Tomography;Usefulness of Magnetic Resonance Imaging

We present a case of cystic renal cell carcinoma( RCC) mimicking a benign complicated renal cyst. In thepresent case, the cystic renal mass was classified as Bosniak classification category II on computed tomography(CT), but magnetic resonance imaging (MRI) demonstrated additional septa and enhancement, whichled to an upgraded Bosniak classification( category III). The patient underwent radical nephrectomy. Histologicalexamination showed the cystic necrosis type of RCC

High-dose Chemotherapy with Peripheral Blood Stem Cell Transplantation for Patients with Poor PrognosisAdvanced Germ Cell Tumor

SUMMARYAbout one half of all advanced germ cell tumor( GCT) patients with poor prognosis defined by the InternationalGerm Cell Cancer Collaborative Group (IGCCCG) die of cancer. We evaluated salvage high-dosechemotherapy (HDCT) with peripheral blood stem cell transplantation (PBSCT) for patients with poorprognosis advanced GCT in Dokkyo Medical University. Three patients with poor prognosis advanced GCTwere treated with HDCT as salvage chemotherapy. Two patients had primary testicular GCT and one patienthad primary mediastinal GCT. Treatment responses were pathological complete remission( CR) in one,surgical CR in one and partial remission (PR) in one. Effectiveness and side effects of HDCT with PBSCTfor poor prognosis cases with advanced GCT were shown in this study. However, further accumulation ofthese studies is needed

ホンガク ドウソウ カイイン ノ キンム ジョウキョウ : ジョセイ イシ シエン オ メザス ヨビテキ ケンキュウ トシテ

雇用の分野における男女の均等な機会及び待遇の確保のために,「男女雇用機会均等法」が成立し,妊娠や出産を理由として職場で不利益な取り扱いをすることは禁じられている1).さらに,「男女共同参画社会基本法」が施行され,2006 年には日本医師会に男女共同参画委員会が設立している2).しかし,我が国の女性医師の就労に影響を与える因子を検討した先行研究によると,性差による就労上の不利益を経験した女性医師が多く,就労格差を女性医師は強く認識しているという結論となっている3).このことは日本ばかりではなく,海外でも同様に報告されている4,5).特に,女性医師は男性医師に比較して,非常勤パートタイムで勤務することが多いと報告されている3,4).パートタイムで働く主たる理由は,出産と子育てである5).多くの女性医師が子育てを優先するために仕方なくパートタイム勤務を選択していることは事実である.また,母性を優先させる選択は職場での昇進・キャリアアップを閉ざすという結果につながる 3).しかし,一方で女性にとって出産や育児は非常に大切な母性の獲得であり,出産を経験した女性医師は医師を職業として選択したことにより満足していると報告されている6).これが女性医師にとってのワーク・ライフ・バランスのジレンマになっている.さらに,現在,医師を養成する大学医学部では,男女は平等に入学できるが,過酷な労働を強いられる大学病院では,女性医師は常勤勤務から離職せざるを得なくなるというアンバランスが生じている.本研究は,本学の女性医師支援のあり方を考える予備的研究として,本学同窓会会員の現況報告を検討し,さらに女性医師支援に関する先行文献を考察することを目的とした