Four New Triterpenoids from the Bark of Euonymus alatus forma ciliato-dentatus.

Four novel lupane-type lupane-type triterpenoids (including three norlupane-type triterpenoids), 17ß-hydroxy-28-norlup-20(29)-en-3-one (1), 3ß,17ß-dihydroxy-28,30-bisnorlupan-20-one (2), 3ß-hydroxy-20-oxo-30-norlupan-28-al (3) and lup-20(29)-ene-3,23,30-triol (4), were isolated together with ten known lupane triterpenoids (5~14) from the bark of Euonymus alatus forma ciliato-dentatus. Their structures were determined from 1D- and 2D-NMR analysis and comparison of their spectroscopic data with literature values. The known compounds (5~14) were reported for the first time from this plant.

[Discharge and introduction to home care for 70 year old terminally ill patient with metastatic gastrointestinal cancer].

There are many problems associated with the discharge and management of terminally ill patients with cancer. A 70-year-old patient with gastrointestinal cancer obstructing his intestinal tract, who is receiving total parenteral nutrition through a central intravenous catheter is being prepared for his discharge from hospital. The effective management of the discharge of this patient and introduction to home care, consisting of visits by physicians and community nurses is described.

[Discharge and introduction to home care for 70-year-old terminally-ill patient with metastatic gastrointestinal cancer].

There are many problems associated with the discharge and management of terminally-ill patients with cancer, A 70-year-old patient with gastro-intestinal cancer obstructing his intestinal tract, who is receiving total parenteral nutrition through a central intravenous catheter is being prepared for his discharge from hospital. The effective management of the discharge of this patient and introduction to home care, consisting of visits by physicians and community nurses is described.

[Experience of Aozora Medical Clinic in EMInet].

We present here the EMInet (Electronic Medical Information network), a closed information network established by the City government and the Medical Association in Matsudo City, Chiba, Japan. In this network, medical information is shared by multiple certified medical facilities under the informed consent of the patients. The medical record is written only by the physician in charge of the patient and reserved in the server computer. The medical record cannot be rewritten or modified by anyone except the physician in charge of the patient. Other medical professionals can only have access to the record. In the emergency room of certified hospitals, a physician can open the patient's record by using the IC card carried by the patient.