A retrospective study of the factors of death by sudden abdominal condition change in terminally ill cancer patients

<b>Purpose</b>: To investigate the characteristics of sudden abdominal condition change that occur in a palliative care unit, we evaluated the association between these conditions and family acceptance at time of death. <b>Methods</b>: We retrospectively investigated the medical records of 30 terminally ill cancer patients who died of sudden abdominal condition change in our unit between January 2010 and March 2013. We focused particularly on the course of sudden change, symptom relief, explanation of the condition, and family acceptance at time of death. <b>Results</b>: The average time from onset of sudden change in abdominal condition until death was 20.6 hours and the median was 13 hours. Of the 30 total cases, 23 occurred in less than 24 hours. Frequent symptoms during the sudden change were abdominal pain in 28 patients, decreased blood pressure in 21, lowering of consciousness in 12 and disturbed behavior/excitement in 10. Impending symptoms were observed in 18 patients. For patients with good acceptance by family at time of death (21 patients), symptom relief was significantly better, frequency of disturbed behavior/excitement was significantly less, and prior specific explanation was significantly frequent, compared to the poor acceptance group (9 patients). The good acceptance group tended to be have a longer hospital stay, as well as longer time between sudden change and death. <b>Conclusions</b>: Death by sudden abdominal condition change came within 24 hours in a majority of cases. We consider that prior detailed explanation and improving symptom relief helps improve family acceptance.

Two Cases of Embryonal Carcinoma / 日本農村医学会雑誌

We show two cases of embryonal carcinoma and discuss the results treatment in this paper. Although the progress of this malignant tumor after treatment was not related to the stadium of the progress of disease, it was found related to the amount of serum AFP and to the immaturity of this neoplasm. In view of the latent metastasis, the combination chemotherapy with Cisplatin was deemed necessary. The dose intensity must be kept 1. Also, we considered it necessary to prescribe the medicine to the patients more than 6 cycles.