[Cell-free and concentrated ascites reinfusion therapy(CART)].

The cell-free and concentrated ascites reinfusion therapy(CART)is a useful palliative maneuver in a patient suffering from ascites. I think that home medical care cooperation is essential to diffuse at home CART.

[Is home palliative care for head and neck cancer patients a possibility ?].

It is likely that home palliative care for head and neck cancer patients could be treatable at general hospitals or clinics whereas combined joint efforts by medical cooperation from specialists, who are specialized in understanding of the singularity and how to cope with the symptoms, are existed.

[The change in home palliative care].

A promotion of home palliative care at our clinic has been built with many factors including a home medical care desired by patient's family, governance of the law, progress of medical measures and an improvement of medical cooperation.

[BNP measurement for perioperative management].

Background: It is difficult to evaluate the tolerance to anesthesia of patients undergoing operations, who have risk factors of congestive heart failure, such as hypertension, old age or various cardiac diseases. BNP (B type natriuretic peptide) is a useful biomarker as a screening tool for LV dysfunction. Therefore we hypothesized that the measurement of BNP may be useful for perioperative management of these patients.

[The medical cooperation in home palliative care with regard to "hospital-medical office and hospital-hospital disease cooperation"].

In the medical cooperation of home palliative care, it often happens to be one-way cooperation. Therefore, it is necessary to have a capability of "home medical support hospital" with functions like helping the patient and his family to prepare for a home care transition and a way to cope with emergency situations.

[The medical cooperation in home palliative care--a design of cooperation with the visiting nursing station].

In home palliative care on site, the trinity of cooperation in "medical-nursing-patient" care is essential. It is necessary to cooperate with the visiting nursing station and to give special considerations in the areas of sharing information, understanding of the difference between in-patient and out-patient and the management of mental health of the caregivers.

[Breast cancer and home care].

In the case of home care treatment of breast cancer patient, it is necessary to consider both social and medical problems based on the characteristics of breast cancer and associated its problems.

[How to use rescue-dose in home hospice care].

In home hospice care, we must try to control steady pain, to give guidance about medication, and to calm anxiety once out of the hospital. We think that it may be important to consult on the issues related to rescue-dose drugs, selection of the drug from the stand point of QOL, and to counsel on behalf of the patient and family.

[Usefulness of fentanyl patch in home palliative care].

Fentanyl patch (Durotep patch) is useful analgesic for terminal patients under home care, but the patients family may feel uneasy because they have to determine the induction dose, prepare the rescue drug, and a variety of drug durability.

[Frostbite due to accidental fall of a portable liquid oxygen device--report of a case].

We experienced a case of frostbite due to the accidental fall of a portable liquid oxygen device. We think this accident occurred because medical staff have little understanding of an oxygen device. We must use medical instruments safety.

[An undesirable process at a sudden change in home palliative care].

Patients under home palliative care may occasionally meet an undesirable end because the family would call an ambulance in the case of a sudden change. It may be caused by lack of family education, a short period under home care, or an administrative proceeding. So, we must be careful in home palliative care.

[Usefulness of fentanyl patch in home palliative care].

Fentanyl patch (Durotep patch) is useful analgesic for terminal patients under home care, but the patients family may feel uneasy because they have to determine the induction dose, a prepare the rescue drug, and a variety of drug durability.

[Frostbite due to accidental fall of a portable liquid oxygen device--report of a case].

We experienced a case of frostbite due to the accidental fall of a portable liquid oxygen device. We think this accident occurred because medical staff have little understanding of an oxygen device. We must use medical instruments safety.

[An undesirable process at a sudden change in home palliative care].

Patients under home palliative care may occasionally meet an undesirable end because the family would call an ambulance in the case of a sudden change. It may be caused by lack of family education, a short period under home care, or an administrative proceeding. So, we must be careful in home palliative care.

[Standard indication of home oxygen therapy for terminal cancer patients].

Home oxygen therapy for terminal cancer patients is not suitable for present standard. As the result of the questionnaire answered by home care doctors, many of them agreed to reconsider the present standard. We propose the following revision, 1.

[Medical network in home palliative care].

Medical network in home palliative care for terminal cancer patients is more difficult compared to that in home care for patients with other diseases because of the following reasons: 1. only a little time for the rest, 2. difficulty of total pain control including physical pain; and 3.