[How to respond to patient families that pursue medical treatment excessively].

It is important to know the mental state of the primary caregiver for patients requiring advanced home care. Herein, we report cases of failed medical treatment due to primary caregivers with psychological problems and a strong desire to have the patient live at home. Of the 486 cases analyzed from August 1, 2004 to October 31, 2012, in 10 cases, the primary caregiver had a strong desire to have the patient live at home. Preventing patients from entering home health care has become more difficult recently. Therefore, establishment of guidelines for interacting with primary caregivers is required. The introduction and application of medical ethical consultation is required for this purpose. The medical ethical consultation is designed to avoid the explanation of medical terminology as much as possible. In order to obtain a detailed understanding of the current state of the patient, it is desirable to pursue a clinical ethical interaction.

[A Study on problems associated with a patient's death during home care, based on the duration of home care and patient's age-why terminal home care is difficult for a patient's family].

When a patient receives home care, an important factor is how the family accepts the patient's death. In this study, we observed that the number of long-term in-home terminal care cases increased, as well as the number of short-term in-home care cases. Moreover, the number of cancer cases among the young population is also increasing. Consequently, how to acceptance of a patient's death varies among their family. When tending to patients, suitable support from the medical staff is required. Additionally, various options need to be provided for terminal care.

Sulfoxide-metal exchange for the synthesis of the 2'-tributylstannyl derivative of 2',3'-didehydro-2',3'-dideoxyuridine (d4u): a general entry to 2'-carbon-substituted analogues of d4U.

Methods are described for the synthesis of the 2'-tributylstannyl derivative of 2',3'-didehydro-2',3'-dideoxyuridine (d4U). Two approaches were investigated: radical-mediated desulfonylative stannylation of the 2'-benzenesulfonyl derivative of d4U and sulfoxide-metal exchange reaction of the 2'-benzenesulfinyl derivative. The latter approach was found to give the desired 2'-stannyl derivative in good yield. It was also shown that manipulations of the stannyl group allowed the introduction of a variety of carbon-substituents to the 2'-position by applying the Stille reaction. The whole reaction sequence has opened up a highly general entry to 2'-carbon-substituted analogues of d4U.