We had a case of lung tuberculosis in an 80 year-old woman, who was diagnosed 3 months after admission to a health service facility for the elderly requiring long-term care. Here we report how we coped with the situation.　　The diagnosis was made by the use of a gene-amplification method. Predonine 7.5 mg/day was prescribed for interstitial pneumonia. TB infection prevention program included a QFT test and chest radiography, and medical interviews was carried out 42 users and 17 staffers of the facility. The program was examined for two years. It was managed by a regional Public Health Center, however, we were involved in many matters offering medical and social information of the subjects to the Center and often notifying the subjects and their family of the schedules and information. Many of the user subjects had been discharged from the facility when the investigation was over, so it was difficult to communicate with them. The QFT test was regarded important and the QFT test positive persons were treated as latent TB infection cases.

  Our palliative care team intervened in a patient with sciatica resulting from metastasis to sacral bone after surgery for rectal cancer. Rapid pain control and a change in the route of rescue drug administration from the stoma were needed. Partial opioid rotation was performed. The dose of 25.2 mg in 72 hours in a transdermal fentanyl patch decreased to 16.8 mg in 72 hours, and the dose of 3.6mg in an hour by continuous intravenous injection of morphine was added. The change in the rescue root to intravenous administration by a patient-controlled analgesia pump gave the patient relief from his pain. He was able to attend his daughter's wedding. His family were all pleased with the relief provided. The advantages of this partial opioid rotation are summed up in the following three points: (1) The required time is relatively short; (2) It can be expedient for analgesia due to the addition of different opioids; and (3) The partial opioid rotation produces fewer adverse effects than a full opioid rotation. Adjustment of the amount of drugs for pain relief in cancer patients is important with the situations of the patient and the family taken into consideration fully.