Hyperkalemia and acute kidney failure associated with preoperative uterine artery embolization for a large uterine fibroid: a case report.

BACKGROUND: Preoperative uterine artery embolization has been shown to help reduce blood loss, with few complications. Most reports indicated that uterine artery embolization is safe for uterine fibrosis; the occurrence of hyperkalemia and acute kidney failure as complications of preoperative uterine artery embolization has not been reported previously. Here we report the occurrence of hyperkalemia and acute kidney failure after preoperative uterine artery embolization for a large uterine fibroid. To the best of our knowledge, this is the first report on the occurrence of hyperkalemia and acute kidney failure after preoperative uterine artery embolization. CASE PRESENTATION: A 48-year-old Japanese woman presented to our hospital complaining of compression in her abdomen and an abdominal mass. Magnetic resonance imaging showed a large uterine fibroid measuring 37.5×27×13.5 cm. Therefore, we planned preoperative uterine artery embolization to help reduce blood loss. However, hyperkalemia and acute kidney failure occurred owing to the development of necrotic tissue after uterine artery embolization; therefore, emergency total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. She experienced 105 g of blood loss intraoperatively. The weight of her uterus was 10.8 kg and the volume was 9964 cm3, with extensive necrotic tissue. Her hyperkalemia and kidney failure resolved after the surgery. CONCLUSIONS: We reported the occurrence of serious complications, including hyperkalemia and acute kidney failure, after preoperative uterine artery embolization for a large uterine fibroid.

Case-control study of green tea consumption and the risk of endometrial endometrioid adenocarcinoma.

OBJECTIVE: To investigate the association between green tea consumption and the risk of endometrial cancer restricted to endometrial endometrioid adenocarcinoma (EEA) using a case-control design in Japan. METHODS: The cases were 152 patients with histopathologically diagnosed EEA, and the controls were 285 healthy women who were matched for age and area of residence with individual cases. The subjects completed a questionnaire regarding health-related lifestyle and reproductive history, and a food frequency questionnaire. Odds ratios (ORs) of EEA for frequency of green tea consumption were calculated by conditional logistic regression analysis. RESULTS: We observed a significant inverse association between green tea consumption and the risk of EEA with a dose-response relationship. The multivariate-adjusted OR of EEA was 0.77 (95% CI: 0.37-1.58) for those in the second quartile of green tea consumption (5-6 cups/week-1 cup/day), 0.61 (0.30-1.23) in the third quartile (2-3 cups/day), and 0.33 (0.15-0.75) in the highest quartile (> or = 4 cups/day), as referenced with those in the lowest quartile (< or = 4 cups/week; p for trend = 0.007). This inverse association was consistently observed regardless of the presence or absence of factors such as obesity and menopause. CONCLUSION: Green tea consumption may be associated with a lower risk of EEA.

Case-control study of coffee consumption and the risk of endometrial endometrioid adenocarcinoma.

This study examined the association between coffee consumption and the risk of endometrial endometrioid adenocarcinoma (EEA) in Japan by a case-control design. The cases consisted of 107 women less than 80 years of age from two medical centers who had been histopathologically diagnosed to have EEA. The controls, selected from the participants of a cancer-screening program, were 214 women, with two controls selected for each case (matched for age and for area of residence). A self-administered questionnaire containing questions to determine dietary and beverage consumption, as well as reproductive history, was distributed to the cases and controls. Conditional logistic regression analysis was used to estimate the odds ratio (OR) of EEA for three levels of coffee consumption with adjustment for potential confounding factors. The multivariate-adjusted OR of EEA for individuals in the highest tertile of coffee consumption (2 to 3 cups or more/day) was 0.4 [95% confidence interval (CI), 0.2-0.9], and that of cases in the intermediate tertile (5 to 6 times/week-1 cup/day) was 0.6 (95% CI, 0.3-1.2), relative to the individuals in the lowest tertile of coffee consumption (3 to 4 times or less/week) (P for trend=0.014). The above association was observed in postmenopausal women (P for trend=0.016), but not in premenopausal women (P for trend=0.90). This study thus revealed an inverse dose-response relationship between coffee consumption and the risk of EEA, and its strong association in postmenopausal women but not in premenopausal women.

Carboplatin-based chemotherapy in patients with gynecological malignancies on long-term hemodialysis.

We report on three cases of long-term dialysis patients with gynecological malignancies who were successfully treated with chemotherapy. Two epithelial ovarian carcinoma patients were treated with a single agent, carboplatin (100-200 mg/m2). One recurrent endometrial carcinoma patient was treated with carboplatin (200 mg/m2) and paclitaxel (135 mg/m2). Hemodialysis was started 2 h after the carboplatin infusion and lasted 4 h in all three cases. All patients tolerated these therapies without significant myelosuppression or severe side-effects. Our findings suggest these regimens are feasible, and the combination of paclitaxel and carboplatin is effective chemotherapy when administered to long-term hemodialysis patients with recurrent endometrial carcinoma.