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To assess the incidence of benign renal lesions in our Japanese clinical experience with surgical resection.A total of 411 renal masses harvested by radical or partial nephrectomy between January 1991 and April 2011 at our institution were retrospectively assessed. The incidence of benign lesions in 1-cm increments in diameter was determined, and a logistic regression model was used to assess relationships between the incidence of benign lesions and other factors.Histological examination confirmed a total of 18 (4.4%) benign lesions. The incidence of benign lesions was 42.8% for nodules1 cm and 10.0% for nodules 1 to2 cm. In contrast, the incidence of benign lesions in each 1-cm increment between 2 and 6 cm was 4.1-4.9%. The incidence of benign lesions 2 to4 cm was 4.8% and of benign nodules ≥6 cm was just 0-1.0%. The incidence of benign lesions ≥2 cm (3.5%) was significantly lower than that of masses2 cm (16.2%; P0.001). Multivariate analysis showed that female gender (odds ratio 3.68) and smaller mass size (2 cm; odds ratio 4.84) were significant predictors for benign lesions.The incidence of benign lesions among renal masses ≥2 cm in diameter was found to be much lower than previously reported. This should be taken into account when designing strategies for the management of suspicious small renal masses.

A 33-year-old male complained of poor vision and visited the ophthalmology department of our hospital. Right iridoncus suspected as a metastatic nodule, was found. A systemic examination was done. Abdominal computed tomographic (CT) scan showed an enhanced mass in the right scrotum, 15 mm in diameter and enlargement of iliac lymph nodes. Chest CT scan demonstrated bilateral enlargement of mediastinal lymph nodes and enlargement of lymph nodes above the collarbone. Since malignant lymphoma or testicular malignancy was suspected, right orchiectomy was planned. A hard and nodular mass at the head of the epididymis, completely separated from the testis, was recognized. Only open biopsy was done, because no malignancy was found by the intraoperative biopsy. Pathological findings of the epididymal tissue revealed non-caseating epithelioid cell granulomas. Sarcoidosis was diagnosed based on pathological findings and systemic evaluations. Steroid ocular instillation therapy was started. To the best of our knowledge, this is the 18th report of epididymis sarcoidosis in Japan.

A retrospective analysis was done on the outcomes of 278 patients who underwent radical prostatectomies at our institutions from November, 1994 to April, 2006. The treatment outcomes measured were disease-specific survival and prostate specific antigen (PSA) biochemical failure-free survival rates. Univariate and multivariate analyses were performed on patient age, clinical T-stage, Gleason sum at the time of prostate biopsy, PSA value before treatment, and any patient history of neoadjuvant hormone therapy. For all patients, the overall survival and the disease-specific survival rates at 10 years were 96.3 and 99.3%, respectively, with PSA biochemical failure-free survival rates at 5 and 10 years of 67.9 and 55.1%, respectively. On multivariate analysis, both the PSA values (20 ng/ml) and Gleason sums (or = 7) were statistically significant independent risk factors for PSA biochemical failure after radical prostatectomy. Neoadjuvant hormone therapy was found to have no effect on PSA biochemical failure.

An 11-year-old female consulted our department with complaints of urinary incontinence and pyuria. She had had a cloacal repair 7 years ago. The radiograph showed four stones in the pelvis. Magnetic resonance imaging showed two diverticula next to the urethra and several low intensity masses in one diverticulum were regarded as stones. Voiding cystourethrography showed normal urinary bladder contraction, although there were residual urine in the diverticula. Preoperatively, these stones were thought to be formed as a result of the long-standing residual urine. Cystourethroscopy showed that the two diverticula existed within the proximal area of the urethral sphincter and four white stones were found in them. Transurethral cystolithotripsy was performed and a surgical staple was found in the core of each stone. The surgical staples had been used for the cloacal repair and they had migrated into the bladder resulted in stone formation. To the best of our knowledge, this is the first report of bladder stones caused by the migration of surgical staples into the bladder after cloacal repair.

The objective of this study was to evaluate the efficacy and toxicity of combined gemcitabine and capecitabine (Gca) chemotherapy in patients with advanced renal cell cancer after immunotherapy failure. Nine patients were enrolled in this trial. Gemcitabine (1000 mg/m(2)) was injected on days 1 and 8, followed by oral administration of capecitabine (1660 mg/m(2)) on days 1-14. The response rate was 11%, with a partial response in one patient (11%), stable disease in five patients (56%) and disease progression in three patients (33%). Grade 3-4 neutropenia was observed in one patient (11%) and thrombocytopenia in two patients (22%). The quality of life (QOL) questionnaire scales showed no significant changes induced by chemotherapy. The median progression-free survival was 4 months with an overall 1-year survival rate of 78%. Gemcitabine and capecitabine chemotherapy can be safely administered as second-line therapy in renal cell cancer patients, maintaining QOL baseline parameters.

A 57-year-old male with a history of right renal cell carcinoma was diagnosed with prostate carcinoma associated with a high PSA level (5.2 ng/ml). Histological examination of the resected prostate specimen obtained by radical prostatectomy revealed well differentiated adenocarcinoma, Gleason score 3 + 3, and pT3aN0M0. After six months of observation, an elevation of PSA level was recognized and local recurrence was suspected. Therefore, radiotherapy with a total of 61.2 Gy was administered. Seventeen months later, bladder cancer was diagnosed. It had to be treated with pelvic evisceration because of suspicious heavy adhesions due to prior treatments. Histology findings were urothelial carcinoma in situ, G3, and pTisN0M0.

This study was designed to assess the intraoperative and postoperative benefits of two techniques for treating renal cell carcinoma (portless endoscopic surgery with radical nephrectomy [PLES-RN] and laparoscopic radical nephrectomy [LRN]) carried out at a single center. Radical nephrectomy with either PLES-RN (14 cases) or LRN (15 cases) was carried out on 29 patients with cT1 renal cell carcinoma. There were no statistically significant between-group differences in patient characteristics (except tumor side), operation time, and amount of blood loss (chi(2) and Fisher's test). No blood transfusions were required in either group. The mean incision length of PLES-RN was not significantly longer than that of LRN. No minor or major complications resulted. From postoperative data, the first intake of fluid (P = 0.07) and food (P = 0.02) tended to be sooner in the PLES group than the LRN group. Postsurgically, white blood cell count and C-reactive protein were not significantly different between the two groups. The added cost of disposable instruments needed in LRN was 111 570 Japanese yen (1115.7 United States dollars). Both techniques are optimal options for surgically treating early renal cell carcinoma. The comparison related to invasiveness between the two methods should be evaluated using a large number of cases focusing on the various aspects for the future.

We report a case of cystic renal cell carcinoma (CRCC). In general, computed tomography (CT) and magnetic resonance imaging (MRI) are sufficient for diagnosing renal cell carcinoma (RCC). However, we often have difficulty in diagnosing CRCC based on these modalities alone. In the present case, to assess the contrast-enhancement of the cyst wall and the septum, we evaluated the usefulness of CT arteriography (CTA) by selective injection of contrast material into the renal artery. We believe that CTA could be a valid option for preoperative radiological differentiation of CRCC.

A 60-year-old male was admitted with bilateral renal masses with a diameter of 50 mm (right kidney), and 15 mm (left kidney) found incidentally by computed tomography. Renal angiography demonstrated neovascularization in the lower pole of the right kidney, but no remarkable findings in the left kidney. We could not deny the possibility of bilateral renal cell carcinoma. Right radical nephrectomy and left partial nephrectomy were performed. The histopathological finding revealed diagnosis of right papillary renal cell carcinoma and left oncocytoma. To our knowledge, this is the third case of renal oncocytoma with synchronous contralateral renal cell carcinoma reported in Japan.

In recent years, in a class of a university, the Web teaching materials came to be used widely. We have developed the teaching materials applied visualization in the information processing education. From them, we report about the example of visualization of the sorting algorithm and the operation procedure of software. The visualization of the sorting algorithm was taken up four kinds of fundamental sorting algorithm (selection sort, bubble sort, insertion sort and quick sort) in the algorithm of computer science, and the visualization which can understand the difference in the technique of each algorithm by two kinds of methods was performed using the animation by Java. The visualization of the operation procedure of software was performed by making Flash movie captured the screen of operation of application software.