Introduction：Although psychosocial support for cancer patients, their family, and those who are bereaved is essential, it is still considered inadequate. Anyone can become a member of the “Gan Cafe” support group, such as those suffering from cancer, those who have survived cancer, family members of cancer patients and those who have lost people to cancer, can get psychosocial support and palliative care support from palliative care unit staff. Case：A 53-year-old male was diagnosed with lung cancer in 2001 and underwent surgery. In 2006 he underwent chemotherapy, as he suffered a relapse. In 2012, while undergoing treatment, he joined the “Gan Cafe” along with his family members. He was able to interact with other members of the group and with the staff of the palliative care unit as a cancer patient, while his wife and children could interact with them as cancer patients family members. Six months later, when being admitted to the palliative care unit, the patient and his family members felt secure as they had become well acquainted with the staff at the “Gan Cafe.” After he had passed away, the wife continued to participate in the “Gan Cafe” as a bereaved family member and the same staff provided her with grief support. Conclusion：Through participation in the “Gan Cafe”, the staff of the palliative care unit was able to provide continuous palliative care with a focus on psychosocial support from the pre-hospital stage to grief support after the patients passed away.

Aortic dissection presents with acute chest or back pain. However, it can be asymptomatic in the acute phase with delayed symptomatic presentation or incidental diagnosis upon chest imaging. We report a case of acute type B aortic dissection subsequent to chronic type A aortic dissection which was difficult to distinguish from acute type A aortic dissection. A 45-year-old man was admitted to a hospital with sudden back pain. An enhanced chest CT revealed a suspected acute type A aortic dissection. The patient was transferred to our hospital and we performed an emergent total arch replacement. Intraoperative findings showed that there were two entries at the origin of the brachiocephalic artery and the left subclavian artery. The ascending aorta presented wall thickening but the descending aorta did not present wall thickening. Histopathologically, the adventitia was obviously thickened with dissection findings in the tunica media. Thus it was diagnosed as acute type B aortic dissection subsequent to chronic type A aortic dissection. Great caution should be taken in asymptomatic chronic aortic dissection.

Entrapment of an intravascular ultrasonography (IVUS) catheter is an infrequent but serious complication associated with percutaneous coronary intervention (PCI). We report a case of successful surgical treatment of an IVUS catheter entrapped in a coronary stent after PCI. An-80-year-old man was admitted to a hospital with sudden anterior chest pain. He underwent PCI to left circumflex branch (Cx) and left anterior descending artery (LAD), followed by IVUS to ascertain stent expansion of the LAD stent. The IVUS catheter became entangled in the stent and could not be withdrawn from the outside. The patient was transferred to our hospital for its surgical removal. For the emergent surgery, we opened the stent region in the LAD and directly removed the IVUS catheter with the twisted stent. The opened place in the LAD was directly closed. Additional coronary bypass grafting involving two vessels was performed. The postoperative course was uneventful with no graft occlusion.