Study Type – Prognosis (case series)
Level of Evidence 4 OBJECTIVE To evaluate the clinical outcomes and histological types of renal cell carcinoma (RCC) arising in patients with end‐stage renal disease (ESRD), and to analyse the relationship of histopathological features with the duration of dialysis. PATIENTS AND METHODS Clinical characteristics and outcomes of 34 patients who had a radical nephrectomy for RCC arising in ESRD between November 1994 and June 2008 were investigated. Archive paraffin‐embedded tissue specimens obtained from 27 patients were histochemically and immunohistochemically analysed to determine the histopathological type. RESULTS There was one death from cancer and one patient with local progression within a median observation period of 29.5 months. Acquired cystic disease (ACD)‐associated RCC, clear cell‐papillary RCC, mucinous tubular and spindle‐cell carcinoma, and Xp11.2 translocation/TFE3 gene fusion were identified in eight, two, three and one patient, respectively. Conventional clear‐cell RCC was the predominant histological type (nine of 15) in patients with a duration of dialysis of <10 years, while ACD‐associated RCC was predominant (seven of 12) in those with dialysis for ≥10 years. Sarcomatoid foci were identified in three patients with dialysis for ≥10 years. Papillary adenoma was microscopically identified as a satellite tumour in 10 patients. CONCLUSION The spectrum of histological types of RCCs arising in ESRD is distinct from that of sporadic RCCs. Patients with a longer duration of dialysis should have particular attention for progression and metastasis. Immunohistochemical profiling is efficient in the histological classification of RCCs arising in ESRD, although knowledge about genetic changes remains to be accumulated.

For patients undergoing incision and drainage of anorectal abscesses, obesity did not affect recurrence. Prompt incision of anorectal abscesses was important to avoid recurrence.

At the posterior wall, a late period hemorrhage is less likely to be found than an early period hemorrhage. It was found that the more piles that were excised, the greater the occurrence of PH.

PurposeInjection sclerotherapy for hemorrhoids has been performed for many years. Currently, 5% phenol in almond oil (PAO) and aluminum potassium sulfate and tannic acid (ALTA) are used as the agents. The purpose of this study was to compare the efficacy of the two agents.MethodsA retrospective study was conducted involving 135 patients who underwent injection therapy for grade 3 hemorrhoids for the first time between 2013 and 2014 (PAO, 55 patients; ALTA, 80 patients). The efficacy was established as the proportion (%) of patients without symptoms such as hemorrhage and prolapse one year after treatment. We investigated four factors—sex, age, number of hemorrhoids, and agent—that might have an influence on the efficacy.ResultsThe efficacies of ALTA and PAO one year after treatment were 75% and 20%, respectively. Only the agent was a significant independent factor (P < 0.01).ConclusionThe results suggest that ALTA is markedly more useful than PAO for injection sclerotherapy for grade 3 hemorrhoids.

Among patients with hemorrhoids receiving AT, ALTA injection sclerotherapy is recommended for those in whom it is difficult to discontinue AT.