[Clinical consideration of percutaneous renal biopsy for renal tumor].

We performed ultrasound-guided biopsies on 14 patients having tumors that were difficult to distinguish as benign or malignant on computed tomography. The study took place from January 2004 to December 2011. Of the 14 tumors biopsied, 12 were malignant, 1 was benign, and 1 was a sampling error. Of the 12 malignant tumors, 7 were primary kidney carcinomas. Six patients received radical or partial nephrectomies, and all had a good prognosis. Three patients with metastatic kidney cancers died of the primary disease. Eleven patients (85.5%) were diagnosed pathologically by biopsies, allowing us to decide the course of treatment. However, because our tests also revealed one sampling error and one unspecified cancer, we determined that there are limitations to a renal biopsy.

Renal transcatheter arterial embolization for autosomal dominant polycystic kidney disease: report of two cases.

We report the results of renal transcatheter arterial embolization (renal-TAE) in two patients with autosomal dominant polycystic kidney disease (ADPKD) treated with hemodialysis (HD). A 73-year-old man and a 65-year-old woman on HD visited our department complaining of abdominal fullness, abdominal pain and appetite loss. Abdominal computerized tomography (CT) revealed polycystic kidneys. Both patients underwent renal-TAE. Approximately 1 month later, the symptoms had improved and CT showed decreased cyst volume. These results suggest that renal-TAE is a useful therapy for patients with ADPKD.

Does lemon candy decrease salivary gland damage after radioiodine therapy for thyroid cancer?

UNLABELLED: Salivary gland dysfunction is one of the common side effects of high-dose radioiodine therapy for thyroid cancer. The purpose of this study was to determine whether an early start of sucking lemon candy decreases salivary gland injury after radioiodine therapy. METHODS: The incidence of the side effects of radioiodine therapy on the salivary glands was prospectively and longitudinally investigated in 2 groups of patients with postsurgical differentiated thyroid cancer with varying regimens for sucking lemon candy. From August 1999 to October 2000, 116 consecutive patients were asked to suck 1 or 2 lemon candies every 2-3 h in the daytime of the first 5 d after radioiodine therapy (group A). Lemon candy sucking was started within 1 h after radioiodine ingestion. From November 2000 to June 2002, 139 consecutive patients (group B) were asked to suck lemon candies in a manner similar to that of group A. In the group B, lemon candies were withheld until 24 h after the ingestion of radioiodine. Patients with salivary gland disorders, diabetes, collagen tissue diseases, or a previous history of radioiodine therapy or external irradiation to the neck were excluded. Thus, 105 patients in group A and 125 patients in group B were available for analysis. There were no statistical differences in the mean age (55.2 y vs. 58.5 y), average levels of serum free thyroxine (l-3,5,3',5'-tetraiodothyronine) (0.40 ng/dL vs. 0.47 ng/dL), and the mean dose of (131)I administered (3.96 GBq vs. 3.87 GBq) between the 2 groups. The onset of salivary side effects was monitored during hospital admission and regular follow-up on the basis of interviews with patients, a visual analog scale, and salivary gland scintigraphy using (99m)Tc-pertechnetate. When a patient showed a persistent (>4 mo) dry mouth associated with a nonfunctioning pattern on salivary gland scintigraphy, a diagnosis of xerostomia was established. RESULTS: The incidences of sialoadenitis, hypogeusia or taste loss, and dry mouth with or without repeated sialadenitis in group A versus group B were 63.8% versus 36.8% (P < 0.001), 39.0% versus 25.6% (P < 0.01), and 23.8% versus 11.2% (P < 0.005), respectively. Permanent xerostomia occurred in 15 patients in group A (14.3%) and 7 patients in group B (5.6%) (P < 0.05). In both groups, bilateral involvement of the parotid gland was the most frequently seen and was followed by bilateral involvement of the submandibular gland. CONCLUSION: An early start of sucking lemon candy may induce a significant increase in salivary gland damage. Lemon candy should not be given until 24 h after radioiodine therapy.

Prognostic factors for survival of patients after curative surgery for renal cell carcinoma: multivariate analysis of 482 cases.

BACKGROUND: Even with curative surgery, renal cell carcinoma occasionally recurs in other organs, with fatal results. In this study, we identified independent prognostic factors for survival in patients with renal cell carcinoma after curative surgery. METHODS: The records of 482 patients (mean age, 61.0 years; range, 17-90 years) who underwent curative surgery for renal cell carcinoma at Gifu University Hospital and its affiliated hospitals between 1991 and 2000 were reviewed. The average follow-up period was 42 months (range, 10-140 months). Clinical characteristics of the 482 patients were divided into three categories: patient factors (sex, age, performance status, and mode of tumor discovery), tumor factors (T classification, N classification, mode of infiltration, histological grade, and venous invasion), and treatment factor (whether or not adjuvant therapy with interferon-alpha was used). Stepwise multivariate Cox proportional hazards regression modeling was performed to identify independent determinants of survival. RESULTS: Of the patient factors, performance status and mode of tumor discovery were independent factors predicting survival. Of the tumor factors, venous invasion and mode of infiltration were independent factors predicting survival. Use or non-use of adjuvant therapy was not significantly associated with survival. Overall, performance status, venous invasion, mode of infiltration, and histological grade were shown to be independent prognostic factors, in descending order of importance. CONCLUSION: Performance status, venous invasion, mode of infiltration, and histological grade, in descending order, were the most important factors predicting survival after curative surgery for renal cell carcinoma.