• Women's Health Nursing
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• v.12 no.1
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• pp.5-11
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• 2006

Purpose: The purpose of this study was to analyze the concept, palliation, in order to enhance understanding of palliative care and ultimately lead to the provision of timely quality palliative care. Method: This study used Walker and Avant s methods for concept analysis. Result: The defining attributes of palliation identified in this study were 1) being limited, 2) responsiveness, 3) leading to positive effects, 4) relativity, and 5) being unsettled. The antecedents of palliation were 1) a problematic condition, 2) appropriate management for the problematic condition, and 3) interaction between the problematic condition and the appropriate management. The consequences of palliation included 1) improvement of a problematic condition and 2) dependency on a management of the problematic condition. Conclusion: Although further studies are required to refine the diverse attributes of the concept of palliation, according to this concept analysis of palliation, palliative care should be introduced at the early stage of disease and constantly provided for the improvement of its negative symptoms.

• Journal of Chest Surgery
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• v.52 no.1
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• pp.32-35
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• 2019

Surgical management of interrupted aortic arch (IAA) with systemic outflow tract obstruction is clearly a challenge. If both ventricles are adequate, the Yasui operation is a useful option. Otherwise, a staged approach through initial hybrid palliation and delayed biventricular repair, tailored to the degree of obstructed outflow, serves to avoid a high-risk neonatal procedure. Herein, we present a patient with IAA and severe systemic outflow tract obstruction whose treatment involved hybrid palliation, followed by a Yasui operation.

• Journal of Chest Surgery
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• v.25 no.1
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• pp.23-31
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• 1992

The ideal approach in the staged management of patients with pulmonary atresia has been a challenging problem and the result has not been always satisfactory. We reviewed our early result of initial palliative surgeries in fifteen cases of pulmonary atresia with interventricular communication Included are eight cases of simple pulmonary atresia with ventricular septal defect and seven cases of pulmonary atresia associated with other complex cardiac anomalies. The ages of the patients were less than one year except one. The morphology of pulmonary vasculature was highly variable and showed unfavorable conditions in most cases. Pulmonary artery was nonconfluent in two. Two-thirds of all cases showed significant problems such as juxtaductal stenosis or diffuse hypoplasia. The ductus arteriosus usually narrowed at its pulmonic end. Initial palliation was done by modified Blalock-Taussig shunt in six, central shunt with or without pulmonary angioplasty in five, right ventricular outflow tract [RVOT] reconstruction in three and direct connection of nonconfluent pulmonary arteries with bilateral cav-opulmonary shunt in one patient. There were 3 hospital deaths. Two of them underwent simultaneous repair of the associated anomaly of TAPVR. Among the six patients who received modified Blalock-Taussig shunt, three needed early second palliative procedure by central shunt, RVOT patch reconstruction and pulmonary angioplasty in each case, All patients who received central shunt showed marked clinical improvement. Among the twelve patients who survived the palliative procedures, two patients underwent total correction 13 months and 18 months after initial palliation respectively. We think that the choice of palliative procedure must be individualized according to the morphology of the pulmonary arteries. More experience and long term follow-up data are necessary to meet this challenging problem.

• Clinical and Experimental Pediatrics
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• v.61 no.7
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• pp.210-216
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• 2018

Purpose: The present study aimed to evaluate progression and prognosis according to the palliation method used in neonates and early infants aged 3 months or younger who were diagnosed with pulmonary atresia with ventricular septal defect (PA VSD) or tetralogy of Fallot (TOF) with severe pulmonary stenosis (PS) in a single tertiary hospital over a period of 12 years. Methods: Twenty with PA VSD and 9 with TOF and severe PS needed initial palliation. Reintervention after initial palliation, complete repair, and progress were reviewed retrospectively. Results: Among 29 patients, 14 patients underwent right ventricle to pulmonary artery (RV-PA) connection, 11 palliative BT shunt, 2 central shunt, and 2 ductal stent insertion. Median age at the initial palliation was 13 days (1-98 days). Additional procedure for pulmonary blood flow was required in 5 patients; 4 additional BT shunt operations and 1 RV-PA connection. There were 2 early deaths among patients with RV-PA connection, one from RV failure and the other from severe infection. Finally, 25 patients (86%) had a complete repair. Median age of total correction was 12 months (range, 2-31 months). At last follow-up, 2 patients had required reintervention after total correction; 1 conduit replacement and 1 right ventricular outflow tract (RVOT) patch enlargements. Conclusion: For initial palliation of patients with PA VSD or TOF with severe PS, not only shunt operation but also RV-PA connection approach can provide an acceptable outcome. To select the most proper surgical strategy, we recommend thorough evaluation of cardiac anomalies such as RVOT and PA morphologies and consideration of the patient's condition.

• 한국호스피스완화의료학회:학술대회논문집
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• 2008.07a
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• pp.6-7
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• 2008

• 대한핵의학회:학술대회논문집
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• 1996.05a
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• pp.158-158
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• 1996

• Nuclear Engineering and Technology
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• v.55 no.1
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• pp.254-260
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• 2023

Skeletal metastases are common in patients suffering from various primary cancers. Radiopharmaceuticals are an effective option for bone pain palliation. In this work, the radiation absorbed dose of ¹⁷⁷Lu-EDTMP radiopharmaceutical was estimated for adult man based on biodistribution data in Wistar rats. The MIRD dose calculation method and the Sparks and Aydogan methodology were applied. The results shows that about 46% of injected activity is cumulated on the surface of the trabecular and cortical bones. Radiation absorbed doses of red bone marrow and osteogenic cells were estimated to about 1.1 and 6.2 mGy/MBq, respectively. The maximum administrated activity was obtained 27 MBq/kg of body weight with an effective dose of 0.23 mSv/MBq. The results were compared with other available data from literature. This study indicated that ¹⁷⁷Lu-EDTMP provides therapeutic efficacy for achieving bone pain palliation with low undesired dose to other normal organs.

• Radiation Oncology Journal
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• v.6 no.2
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• pp.289-293
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• 1988

Radiation therapy has been used as adjuvant therapy or primary treatment for inoperable, remnant or recurrent cancer. Many authors reported good palliation effect by external irradiation or interstitial therapy, but the report of intracavitary irradiation for recurrent, inoperable rectal cancer is very rare. We experienced a case of recurrent adenocarcinoma of rectum along fistula tract after laparotomy and postoperative radiotherapy who achieved very good palliation by intracavitary irradiation. Even though we have only good palliation without impressive survival improvement in this case, we hope that this technique may achieve good local control In other similar patients.

• Journal of Chest Surgery
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• v.22 no.2
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• pp.256-264
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• 1989

Modified Blalock-Taussig operation remains the standard technique of systemic-to-pulmonary artery shunt in patients of congenital heart disease with decreased pulmonary blood flow. We reviewed the 41 patients who had been performed modified Blalock-Taussig operation from March 1985 to Feb. 1988, and angiographically measured pulmonary artery size before and after shunt, and calculated pulmonary artery index [PAI] and ratio of left and right pulmonary artery to descending aorta[[LPA+RPA]/dAo]. The mean duration of palliation after shunt operation was 624 days and mean age of the patient at shunt operation was 3.59 years. Mean PAI increased significantly from 131.15*67.11 mm2/M2 preoperatively to 232.70*84.46 mm2/M2 postoperatively. Mean ratio of right and left pulmonary artery to descending aorta also increased significantly from 1.48*0.40 preoperatively to 1.92*0.50 postoperatively. All patients manifested clinical improvement; there was mean decrease in hematocrit of 8.95%, mean increase in arterial oxygen saturation of 11.08%. Pulmonary arterial growth was not influenced by age at operation, initial pulmonary artery size, or graft size, but significantly influenced by antegrade flow. The patients who have some antegrade flow were in more increase of PAI. There were no linear correlation between change of PAI, change of [[LPA+RPA]/dAo], SaO2, and duration. But, according to Scatterplot between change of PAI and duration, some complex correlation was suggested and mean PAI was decreased after 2-year palliation. We concluded that modified Blalock-Taussig operation is excellent palliative surgery for pulmonary artery growth especially on the patient who have some antegrade flow, and the proper duration of palliation was about 2 years.

• Journal of Digestive Cancer Research
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• v.2 no.1
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• pp.1-4
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• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.