1.Analysis of administrative data to investigate end-of-life cancer care in a Japanese university hospital: development of methodology
Yuko Sato ; Mitsunori Miyashita ; Kenji Fujimori ; Jun Nakaya ; Yoko Fujimoto ; Makoto Kurihara ; Kazuki Sato ; Chikashi Ishioka
Palliative Care Research 2015;10(3):177-185
Purpose:To explore a methodology for evaluating end-of-life (EOL) cancer care using diagnosis procedure combination (DPC) administrative data. Methods: We investigated care provided to inpatients whose deaths were attributed to cancer and occurred between August 2010 and December 2012. We measured the quality of palliative care by dividing the decedents into two groups: those who died in the palliative care unit (PCU) and those who died in the general wards(GW). Results: A total of 311 inpatient deaths were identified as cancer deaths. Of these, 147 patients were included in the PCU group and 164 in the GW group. We calculated the DPC data as follows: the rates of chemotherapy administered within 30 days before death (PCU 0%, GW 27%) and within 14 days before death (PCU 0%, GW 10%), admission to the intensive care unit (PCU 0%, GW 2%), life-sustaining interventions (PCU 0%, GW 3%), rehabilitation sessions (PCU 10%, GW 26%), emergency admission (PCU 2%, GW 27%), and antibiotics (PCU 32%, GW 28%). In the PCU group, rates of chemotherapy and emergency admission were significantly lower(<0.0001;<0.0001, respectively), and rehabilitation sessions were significantly higher (p=0.0002) than in the GW group. Conclusion: EOL care in a university hospital can be easily investigated using DPC data. Some limitations are the single-site study design, the health insurance system, and secondary use of administrative data. However, this methodology may be adapted to investigate the entire Japanese claim database and to evaluate EOL cancer care.
2.Graphiumins I and J, New Thiodiketopiperazines from the Marine-derived Fungus Graphium sp. OPMF00224.
Takashi FUKUDA ; Kenichiro NAGAI ; Yuko KURIHARA ; Akihiko KANAMOTO ; Hiroshi TOMODA
Natural Product Sciences 2015;21(4):255-260
Two new thiodiketopiperazines (TDKPs), designated graphiumins I (1) and J (2), were isolated from the culture broth of the marine-derived fungus Graphium sp. OPMF00224 by solvent extraction, silica gel column chromatography, and HPLC. Their absolute structures were elucidated by spectroscopic analyses (1D and 2D NMR data, ROESY correlations, and CD data) and chemical methods. They were found to be structurally rare TDKPs with a phenylalanine-derived indolin substructure. Compounds 1 and 2 inhibited yellow pigment production by methicillin-resistant Staphylococcus aureus (MRSA) with IC50 values of 63.5 and 76.5 microg/ml, respectively, without inhibiting its growth, even at 250 microg/ml.
Chromatography
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Chromatography, High Pressure Liquid
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Fungi*
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Inhibitory Concentration 50
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Methicillin-Resistant Staphylococcus aureus
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Silica Gel