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Whether the presence or absence of notification about the blood sampling date affects the serum phosphate concentration was examined. After periodical sampling at the beginning of the week with 2-day interval for regular dialysis, the blood was sampled on the midweek day with 1-day interval for dialysis upon the patient's consent right before sampling without an advance notification. In the next month subsequently periodical sampling at the beginning of the week and the sampling on the midweek day were performed after notification of the twice blood sampling before 1 week in advance. Then both serum phosphorus data were comparably investigated. In case the sampling was not notified, there is no difference in the serum concentration between the beginning of the week and the midweek day. On the other hand, in case the sampling was notified, the serum concentration significantly decreased on the weekday compared to that at the beginning of the week. It therefore was risky that the serum phosphorus concentration at the beginning of the week with 2-day interval for dialysis was presumed to be higher value than that on the midweek day with 1-day interval for dialysis. We need to consider the possibility that the presence or absence of notification about the blood sampling date affects the level of serum phosphorus concentration.

We report the case of a 67-year-old man with NK/T cell lymphoma of the larynx accompanied by hemophagocytic syndrome (HPS) who reported throat paresthesia and was referred for evaluation of a laryngeal tumor extending from the left false vocal cord to the arytenoids. Two separate biopsies from the larynx yielded a histological diagnosis of NK/T-cell lymphoma, nasal and nasal type. Since he showed pancytopenia and remittent fever soon after admission, bone marrow was examined and showed severe hemophagocytosis, leading to a diagnosis of HPS. He died of circulatory and respiratory distresses due to HPS about one month after admission. HPS develops with symptoms of fever, cytopenia, and liver dysfunction, and is characterized by systemic proliferation of benign hemophagocytic histiocytosis in the bone marrow, lymph nodes, liver, and spleen. To the best of our knowledge, this is only the second case of NK/T-cell lymphoma of the larynx with hemophagocytic syndrome to be reported in the Japanese literature.

We ranked prognostic factors to retrospectively evaluate the clinical significance of interferon alpha (IFN-alpha) therapy in patients with Robson stage IVB renal cell carcinoma. A total of 44 Robson stage IVB renal cancer patients were divided into 2 groups, one with more than 6 months administration of IFN-alpha (3-7 times a week: group A) and another without any IFN-alpha administration. The distribution of these 2 groups was not randomized. In addition to IFN-alpha therapy, survival was analyzed with respect to performance status (PS), mass reductive nephrectomy, concomitant use of other cytotoxic therapies, the number of metastatic organs, growth type, site of metastasis and the period of diagnosis, using a multivariate method with Cox proportional hazards regression. The multivariate analysis showed administration of IFN-alpha to be the most significant factor influencing a good prognosis. Improved survival was also significantly correlated with slow growing type and good PS. Among group A, a significant favorable prognosis was obtained in patients with the responses of no change (NC), partial response (PR) and complete remission (CR) 6 months after initiating administration of IFN-alpha, as well as with good PS and a slow growing type carcinoma. We conclude that IFN-alpha therapy might improve the prognosis of patients with Robson stage IVB renal cell carcinoma, especially, in cases when a greater than NC response is obtained after 6 months administration of IFN-alpha.