[Palliative Care for Non-cancer Patients].

Although palliative care has been developed and implemented as care for cancer pain, it is holistic care for suffering that includes physical, psychosocial and spiritual pain of life-threatening illness. It turned out that non-cancer patients in the end-stage are also suffering from various pain that should be treated as cancer patients. Trajectories of illness in non-cancer patients are with more gradual decline than those of cancer patients with steady progression and it is often difficult to make decision about end-of-life.

[Successful Subarachnoid Phenol Block Therapy in a Patient with Pelvic Tumor-related Rectal Tenesmus].

We report a successful case of subarachnoid phenol block therapy in a patient with refractory rectal tenesmus caused by metastatic breast cancer. A 50-year-old woman with pelvic metastasis of breast cancer had the constant desire for defecation and anal discomfort, although analgesics including opioids relieved her from low abdominal and anal pain. Computed tomography revealed rectal invasion of metastatic breast cancer and the diagnosis of tumor-related rectal tenesmus was made.

Methadone for Patients with Malignant Psoas Syndrome: Case Series of Three Patients.

Background: Malignant psoas syndrome (MPS) is a relatively rare syndrome that accompanies malignancy; the pain associated with MPS is often difficult to control. Methadone is known to be effective in relieving both nociceptive and neuropathic pain.

Objective: Herein we describe treatment strategies for three patients with MPS, diagnosed by imaging and clinical findings, who responded to methadone treatment.

[A case of dexmedetomidine administration for slight end-stage sedation in a patient with sudden continuous bleeding].

We report a case of sudden fatal bleeding during the treatment of pancreatic cancer. The patient underwent palliative treatment for his symptoms with hydroxyethyl starch (HES) and continuous dexmedetomidine. He suffered from advanced pancreatic cancer, underwent gastrojejunostomy, and was scheduled to undergo chemotherapy.

[Efficacy of CT-guided splanchnic nerve block for persistent pain after fluoroscopy-guided nerve block in a patient with advanced pancreatic cancer].

We report a successful case of CT-guided splanchnic nerve block in a patient with advanced pancreatic cancer. A 76-year-old woman with epigastric distress was diagnosed with pancreatic cancer with multiple metastases. She underwent chemotherapy, but decided on best supportive care when her performance status worsened.

[Three successful cases of relieved abdominal fullness by thoracic epidural analgesia].

We report three successful cases of treating intractable abdominal fullness associated with cancer by continuous thoracic epidural analgesia. Case 1 was a 31-year-old woman with sarcoma of the uterus suffering from back and epigastric pain; abdominal fullness was treated by continuous epidural analgesia with ropivacaine and morphine. After epidural analgesia, symptoms disappeared and removal of ascites was unnecessary.

[Three successful cases of continuous dexmedetomidine infusion for the treatment of intractable delirium associated with cancer pain].

We report three cases of successful treatment of intractable delirium associated with cancer pain with continuous dexmedetomidine (DEX) infusion. Case 1 : An 83-year-old man receiving oral oxycodone for lung cancer pain developed delirium. He was resistant to haloperidol infusion, oral quetiapine, and opioid rotation.

[Intrathecal segmental analgesia with a single dose of bupivacaine for cancer pain in the abdominal wall].

A 48-year-old woman, diagnosed as colon cancer with metastases in the liver, lung, bone and left rectus abdominis, developed refractory left abdominal pain in spite of escalating administration of opioids and nerve block therapy, and intrathecal analgesia was applied. The tip of the catheter was intrathecally placed at the level of the T8 vertebra and pain relief was obtained with a daily dose of bupivacaine 36 mg producing segmental analgesia of the area between the 7th and 10th thoracic segments and preserving sensory and motor functions of the lower limbs. Face scale scores decreased from 5/6 to almost 0 after induction of the intrathecal analgesia.

A novel video-assisted anatomic segmentectomy technique: selective segmental inflation via bronchofiberoptic jet followed by cautery cutting.

Objective: Segmentectomy is an anatomic parenchyma-sparing resection that is recently being performed for small-sized lung carcinoma and constitutes a useful procedure in a thoracic surgeon's armamentarium. We have generated a new technique that improves the identification of the intersegmental border and whose clinical utility we evaluate in this study.

Methods: Under bronchofiberscopy, jet ventilation is selectively applied to the burdened bronchus to develop an anatomic plane between the inflated segment to be resected and the deflated area to be preserved.