Prophylactic effect of rikkunshito, an herbal medicine, for chemotherapy-induced nausea in thoracic cancer patients receiving carboplatin-based chemotherapy.

Rikkunshito has been shown to improve upper gastrointestinal symptoms and anorexia. The aim of this study was to evaluate whether rikkunshito improves chemotherapy-induced nausea in thoracic cancer patients receiving carboplatin (CBDCA)-based chemotherapy. A retrospective before-and-after comparison study was conducted in patients with thoracic cancer receiving the first cycle of CBDCA-based chemotherapy. Among 61 eligible patients, 34 received standard antiemetic therapy with a combination of 5-hydroxytryptamine-3 receptor antagonist and dexamethasone from September 2012 and June 2013 (standard group), while the other 27 received the standard antiemetic therapy plus oral rikkunshito from July 2013 and December 2014 (rikkunshito group). The rates of no nausea showed no significant difference between the standard and rikkunshito group (Overall phase: 64.7 % for standard group vs 74.1 % for rikkunshito group, p = 0.579). Subgroup analysis indicated that, in female patients, the rates of no nausea in rikkunshito groups was significantly higher than in standard group (overall phase: 44.4 % vs 100 %, p = 0.034). Rikkunshito did not demonstrate an additional prophylactic effect on standard antiemetic therapy for nausea in patients with thoracic cancer receiving CBDCA-based chemotherapy, but showed a prophylactic effect of nausea in female patients.

Identification of Blue Pigment Formed in a D-Xylose-Glycine Reaction System.

D-Xylose (1 M), glycine (0.1 M), and sodium hydrogencarbonate (0.1 M) were dissolved in aqueous 60% ethanol at pH 8.1 and left at 26.5°C for 2 days in a dark room under nitrogen displacement. Blue pigment was isolated and purified from the blue solution by anionic exchange and gel filtration chromatographies. Blue pigment which was designated Blue-M1 (blue Maillard reaction intermediate-1) was identified as 5-{[1,4-(dicarboxymethyl)-5-(2,3-dihydroxypropyl)-2-pyrrolo[3,2-b]pyrrolyl]methine}-1,4-(dicarboxymethyl)-2-(1,2,3-trihydroxypropyl)-pyrrolo[3,2-b]pyrroly-lium. Blue-M1 is supposed to be a dimer of yellow colored pyrrolopyrrole-2-carboxaldehyde compounds. Blue-M1 that reacts readily to yellow compounds has a polymerizing activity, suggesting it is an important Maillard reaction intermediate through the formation of melanoidins.

A Tentative Measurement of Brown Pigments in Various Processed Foods.

A tentative method for measuring brown pigment in food was proposed and applied to 25 items of commercial browned foods. The principle was based on the assumption that any brown pigment with general absorption in the visible wave-length spectrum is quantitatively equivalent to melanoidin prepared from a model system of the Maillard reaction. The spectral curve for general absorption was represented by the equation dE/dλ=-kE (E, absorbance; λ = wave length; k = constant > 0), of which the value k w as found to correlate with the molecular weight and the molar extinction coefficient and to serve as an empirical parameter for the measurement of brown substances in different foods.

Inhibiting Effect of Browned Processed Foods on Trypsin.

Inhibition of proteases was examined in browned foods including soy pastes, soy sauces, fish sauce, sauces, teas, coffees, and others in association with melanoidin, a Maillard product, which had been found to be a potent inhibitor of trypsin. Most of the foods were effective in restraining trypsin activity based on hydrolysis of N-α-benzoyl-DL-arginine-p-nitroanilide, while being ineffective on chymotrypsin except for black tea and cola. Especially, teas were noted for their strong inhibitory effect on trypsin. The color intensity of the foods in terms of optical density at 400 nm appeared not to correlate with the extent of inhibition except for soy sauces.

Kinetic Analysis of the Inhibition by Melanoidin of Trypsin.

The inhibition by melanoidin of trypsin was investigated in a kinetic approach. Melanoidin was prepared by the Maillard reaction between D-glucose and glycine, and BANA was used as a substrate. The inhibition was found to follow a non-competitive mode with a Ki of 5.8% and to be exerted through an electrostatic interaction between melanoidin and trypsin. Approximately 20% of the activity of trypsin survived even at a greatly increased concentration of melanoidin. The inhibiting mechanism of melanoidin might be due to an allosteric effect, which was probably different from a proteinaceous inhibitor such as ovoinhibitor diminishing trypsin-activity completely. The melanoidin molecule was thought to trap a great number of trypsin molecules, binding them and reducing their activity.

[A case of hypertrophic obstructive cardiomyopathy with left atrial giant thrombus during anti-platelet therapy].

A case of a 77-year-old female with hypertrophic obstructive cardiomyopathy having the left atrial "giant" thrombus was reported; the diagnosis of the localization and size of the thrombus was made by employing echocardiography and contrast enhancement computed tomography as well. The clinical record indicated that the thrombus formation, which happened in the course of the antiplatelet therapy, was to be considered due to the complicated condition of the patient, i.e., the combination of atrial fibrillation, low cardiac output, enlargement of left atrium and left ventricular diastolic disfunction, which assumed to predispose the giant thrombus. Avoiding the surgical removal of the thrombus because of the poor conditions of the patient, urokinase treatment was attempted, but not successful, which might be derived from the nature of the thrombus already organized. In general, left atrial giant thrombus is very uncommon status; if any, it is occasionally complicated with mitral stenosis. The case reported deems to be very rare, enough worthy to be reported.