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研修医日記/医療法人社団 札幌皮膚病理診断科
Sapporo Dermatopathology Institute
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Kau/研修医日記1
 研修日記を書くのが遅れている間に、あれよあれよと3か月経ってしまいました…。同時期に研修を開始した服部くんも帰ってしまいました…。今はマレーシアから来たリー先生とエジプトから来たムスタファ先生と研修しています。あやしい英語で喋らざるを得ませんが、いい練習になっています。

 次に来る研修生の参考になるように、研究所のごく近辺の知っておくと食事に便利な店について少し書きます。



●「セイコーマート」:はすむかいにあります。北海道でよくみるコンビニ。

●「Boston Bake」:安くておいしいパン屋。20時以降は4割引きです。

●「デリカフェ」:研究所の隣です。350円からお弁当あります。たまにアイスコーヒーやかき氷をサービスして頂けます。

●「Hotto Motto」も近くにあります。

●「ファイアーバーグ」one coin、鉄板ハンバーグセット。1kgを15分以内に食べると無料になります。

●「心」割と有名なスープカレーです。徒歩5分。

●「石田珈琲」おいしい珈琲。和みます。南に徒歩3分。

●「孔子飯店」四川中華。どうみてもただの中華料理屋ですが密かな名店です。麻婆豆腐は本格激辛だそうです。北大の真正面。

●「南路屋」お好み焼き、モダン焼き、焼きそば。北大生多し。北に徒歩2分。


研修は楽しくやっていますので、研修内容は今回は割愛します。(終)
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Immunohistochemistry in cutaneous adnexal carcinoma vs metastatic adenocarcinoma/Lee Bang Rom
By Lee BR

Immunohistochemistry in cutaneous  adnexal  carcinoma vs metastatic adenocarcinoma(Lee)

Immunohistochemistry in cutaneous  adnexal  carcinoma vs metastatic adenocarcinoma(Lee)-1

Figure 4. Immunohistochemical panel applied to ductal cutaneous metastatic breast carcinoma: mammaglobin (A), p63 (B), CK5 (C), CK14 (D),
and CK17 (E); and to sweat gland carcinoma (porocarcinoma): mammaglobin (F), p63 (G), CK5 (H), CK14 (I), and CK17 (J) (original magnifications
3100 [A through J] and 3400 [insets]).

Immunohistochemistry in cutaneous  adnexal  carcinoma vs metastatic adenocarcinoma(Lee)-2

Reference : Marian Rollins-Raval et al. An Immunohistochemical Panel to Differentiate Metastatic Breast Carcinoma to Skin From Primary Sweat Gland Carcinomas With a Review of the Literature. Arch Pathol Lab Med—Vol 135, August 2011
Lee Bang Rom/Life in Institute of dermatopathology Sapporo. First month
Arrival:

The warm summer and the blooming flowers along the Chitose’s airport runway lined up for my arrival. I was expected by Dr kimura as his domestic flight from Tokyo was half an hour later than mine. However, my exit through the custom gate was delayed due to the congested tourists. Rushing toward the JR station, finally I met Dr Kimura again; he was in the similar casual wears and beret like hat.

Later, I was brought to the Ackerman Memorial Sapporo Dermatopathology Institute. The collection of antique microscopes at the institute’s foyer was stunning. A brief tour around the institute gave me a rough idea about its operation. My accommodation was well arranged by Miss Keiko Sadahisa; a staff from NPO Japan Dermatopathology Promotion Organization.

Next morning, I was introduced to all the hardworking and friendly staffs. I am pleased to have Dr Kaku and Dr Mostafa as study-mates.

Life in Institute of dermatopathology Sapporo-1

Learning experience:

The main aim for this attachment is to upgrade my diagnostic skill. Despite working as pathologist for more than 4 years, I had never encountered more than 200 cases in a day. The enormous quantity and variety of cases provide a wide learning opportunity for me. Furthermore, Dr Kimura and Dr Anan are working extremely hard in their diagnostic working; in both speed and accuracy of each case.

Upmost, the environment for learning in this institute is superbly conducive. There are abundant collections of both historical and updated textbooks as well as latest printed journals. The trainees often discuss and share the difficult cases. Additionally, everyday, there are 10 -20 of interesting cases on NPO Japan Dermatopathology Promotion Organization website for viewing. It eases the communication of pathologists and enhances the knowledge sharing.

To be honest, I am very glad and honoured with such learning environment and training method. I feel like being a medical student again. Within the first month, I had solved and corrected some practical diagnostic issues even a simple one such as differencing dilated pore of Winer and follicular cyst of infundibular type.

I had also strengthened my knowledge in basis dermal histology by revising what I had learned. “The illiterates of the 21st century will not be those who cannot read and write but those who cannot learn, unlearn, and relearn”- a quotation by Alvin Toffler. “Learn, unlearn and relearn” is the quotation I have adapted to correct my previous ideas and concepts in order to improve my dermatopathology knowledge.

Dr Kimura is such a skillful “morphologist” and generous teacher. He is never hesitating to share his wisdom and wide experience with us. “Teaching is Learning” this is another quotation by Kimura Sensei, which refer to the benefit of sharing the knowledge we learned. I believe it will be wise to produce English version of Kimura’s quotation 「心に残る木村先生の一言」.

“Diagnosis by your spinal reflex” is the term refers to our ability to recognize details of the pathology and come out with an instant correct diagnosis. I wish I will acquire such skill within this 6 months duration.

Daily living:

Jogging through the Hokkaido University Gingko Avenue becomes my evening routine. I will train well for the coming Hokkaido’s marathon. I love the greenery of the fields and trees in summer.

I shall improve my Japanese language deficiency by attending a conversation class. Unfortunately, few Monday classes were cancelled due to holiday. I need to learn the spoken Japanese medication term urgently so that I can fully understand the CPC session.

During the end of my second week, Dr Kimura treated us at Indian’s halal restaurant as a farewell lunch for Dr Mostafa.

Life in Institute of dermatopathology Sapporo-2

Mostafa/June report
In June, I have continued my training program progressively. I I have finished preparing most of the virtual slides for common, rare, and very rare skin diseases that will be included in Mostafa's inflammatory skin diseases folder. I have finished around 85% of this big project.

Although I feel good progress in my training program, every now and then I have some pitfalls in diagnosis which encourage me to study more and more

During June also, I have enjoyed the farewell party done for Dr. Hattori. I have prepared my own food suitable for muslims. I asked Dr. Hattori to keep in contact with me and I wish brilliant future for him.

In addition, I continued to collect very rare cases in the institute, and after discussion with Dr. Kimura, I plan to prepare some case reports using those cases.

In June, the weather has changed dramatically to be slightly hot. I am still enjoying beautiful gardens in Sapporo
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