We experienced a case that right massive pleural effusion was successfully controlled with Denver shunt from the right chest cavity to right femoral vein. A 80-years-old woman had received hemodialysis due to chronic renal failure twice in a week. She was diagnosed as right breast cancer and underwent right breast conserving surgery at December, 2008. In postoperative follow-up duration, she had difficulty in breathing and visited to the emergency room in our hospital. She was diagnosed as respiratory failure due to right massive pleural effusion from the X-ray result and the blood gas analysis. There was no pleural effusion within the left chest space. No malignant cell was detected in the effusion. We thought that diuretics and shunt tube from the right chest cavity to the abdominal cavity would be ineffective because of her chronic renal failure, and for that reason, we placed the shunt tuve from the chest cavity to the right femoral vein. Respiratory failure and the quality of life were successfully improved for about 7 months by using it. Palliat Care Res 2011; 6(1): 301-307

Sho-syndrome was analyzed by cluster analysis of answers to a set of questionnaire presented to first-visit patients at a hospital of Japanese-Oriental (Kampo) medicine. The answers from 270 new patients were classified into 3 groups by hierarchical cluster analysis, with a total of 202 non-female related items. We looked at which Sho-syndromes of metabolic (Mb: “Kan-” _??_-), gastrointestinal (Gi: “Hi” _??_-), respiratory (Rp: “Hai-” _??_-), or water and mineral-balance (Wm: “Zin-” _??_-) deficiency (“Kyo” _??_) disorders were included, in one of the groups at high frequencies. Water and mineral-balance deficiency disorders were in Group II and III, while metabolic deficiency disorders were in Group III. We conclude that the results of this analysis support the rationale for the empirical determination of Sho-syndrome, in addition to pulse diagnosis by Kampo-clinicians who examine patients.