Molecular Structure of Gardenia Blue Pigments by Reaction of Genipin with Benzylamine and Amino Acids

Genipin was reacted with benzylamine and several amino acids to prepare gardenia blue (GB). The time-course of GB formation with benzylamine was monitored by high-performance liquid chromatography (HPLC), liquid chromatography time-of-flight mass spectrometry (LC-TOFMS), and ¹H and ¹³C NMR measurements. In this experiment, we determined the molecular structures of some intermediates using accurate masses and additional NMR techniques such as heteronuclear multiple bond correlation (HMBC). GBs with amino acids (GB-AAs) were characterized by both liquid and solid-state NMR measurements. Interestingly, many significant peaks appeared in the solid-state NMR spectra, although the ¹³C NMR spectra from solution samples did not show any distinct peaks. Therefore, we determined that GB-AAs had an alternating copolymer structure composed of methyne and 5H-2-pyrindine, which was substituted by amino acids at N atom and linked with methyne at 5 and 7 positions. To confirm this molecular structure, the pyrolysis gas chromatography-mass spectrometry (GC-MS) measurement of GB-AAs was carried out, and 5H-2-pyrindine and its methyl derivatives were formed as main pyrolysis products from the polymer chains.

Abstract OT1-02-01: Phase II neoadjuvant trial of nanoparticle almumin-bound paclitaxel and trastuzumab in patients with node-negative, Her-2 positive breast cancer (OMC-BC04)

Background: Neoadjuvant chemotherapy plus trastuzumab results in a 30% to 50% pathologic complete response (pCR) rate in HER-2 positive breast cancer and has been associated with improved therapeutic outcomes. Thus, the pCR rate can be useful in evaluating novel agents in this patient population. Albumin-bound (nab)-paclitaxel can reduce the toxicity of Paclitaxel while maintaining its efficacy. We reported that neoadjuvant therapy using Anthracycline based regimens (EC,AC,FEC) followed by a combination with nab-Paclitaxel and Trastuzumab was effective and safe by OMC-BC01 Study (Tanaka et al. Clin Breast Cancer 15:191-196). The pCR rate was 36% and 71% in the patients with estrogen receptor-positive and negative cancer, respectively. In addition, Tolaney et al. showed that adjuvant Paclitaxel and Trastuzumab for node-negative, HER-2 positive tumors measuring up to 3 cm in greatest dimension was associated with patients outcomes that were better than expected on the basis of historical data (Tolaney et al. N Engl J MED.2015 Jan 8:372(2):134-141). We conducted a clinical Phase II, multicenter, neoadjuvant trial of combination with nanoparticle albumin-bound Paclitaxel and Trastuzumab in patients with node-negative, Her-2 positive, estrogen receptor-negative breast cancer measuring up to 3 cm in greatest dimension.

Patients and Methods: nab-Paclitaxel and Trastuzumab as neoadjuvant therapy in patients with Her-2 positive, node-negative, estrogen receptor-negative breast cancer measuring up to 3 cm in greatest dimension. Patients are treated with neoadjuvant nab-Paclitaxel (260mg/m2) and Trastuzumab q21d x 4, and undergo surgery 4-6 weeks later from completing chemotherapy. The primary endpoint, pCR is defined as no evidence of invasive tumors in the final surgical sample both in the breast and axillary lymph nodes. Secondary endpoints include objective clinical response rate, histological response rate, disease-free interval, rate of breast conserving surgery, and the safety of the treatment.

Accrual: Presently, a total number of 1 patient have been included since start of the study. The expected end of accrual of 30 patients will be the last quarter 2018.

Citation Format: Iwamoto M, Tanaka S, Koda C, Kawaguchi K, Terasawa R, Sato N, Fujioka H, Kimura K, Uchiyama K. Phase II neoadjuvant trial of nanoparticle almumin-bound paclitaxel and trastuzumab in patients with node-negative, Her-2 positive breast cancer (OMC-BC04) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-02-01.

Abstract OT3-02-01: Randomized phase II study of Hangeshashinto (TJ-14) for chemotherapy induced oral mucositis in patients with breast cancer (Hangesha-B study)

Background: Oral mucositis is a common complication of systemic chemotherapy for cancer, and is associated with higher risk of infection, pain, chemotherapy dose reduction. Severe mucositis impairs oral function and seriously affects nutrition and quality of life of the patients.

Hangeshashinto (TJ-14) is a traditional Japanese herbal (Kampo) medicine reduces the level of prostaglandin E2 and affects the cyclooxygenase activity, and alleviates chemotherapy induced oral mucositis. We conducted a randomized phase II trial to investigate whether Hangeshashinto (TJ-14) prevents or controls chemotherapy induced oral mucositis.

Patients and Methods: Patients who develop moderate to severe chemotherapy induced oral mucositis (WHO grade>1) during any cycle of chemotherapy are randomly assigned to receive either Hangeshashinto (TJ-14) (n=25) or placebo (n=25). Patients receive the administration of Hangeshashinto (TJ-14) or placebo for 3 weeks at the beginning of the next course of chemotherapy. The patients are advised to dissolve 2.5g of Hangeshashinto (TJ-14) or placebo in 50ml drinking water, and divide it into twice or three times in an oral cavity. Patients rinse their oral cavity with it three times daily. The signs of oral mucositis is assessed by the investigator during the screening cycle. The CTCAE v4.0 grading is used to assess the severity of oral mucositis. The primary endpoint is duration time of oral mucositis, and secondary endpoints include incidence of oral mucositis, incidence of diarrhea, blood levels of CRP, The change of body weight, and blood levels of albumin.

Accrual: This study began in June 2015. The expected end of accrual of 50 patients will be the last quarter 2017.

Citation Format: Iwamoto M, Umezaki N, Matsuda J, Kawaguchi K, Terasawa R, Sato N, Fyjioka H, Kimura K, Tanaka S, Uchiyama K. Randomized phase II study of Hangeshashinto (TJ-14) for chemotherapy induced oral mucositis in patients with breast cancer (Hangesha-B study). [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT3-02-01.

Abstract P2-19-06: Breast conserving surgery using volume replacement with oxidized regenerated cellulose: A cosmetic outcome analysis

Background: Breast conserving surgery (BCS) is a standard procedure for patients with early stage breast cancer. However, as the objective of BCS is to obtain both local control and a cosmetic outcome, it may lead to unsatisfying cosmetic results when the volume of resected tissue is large in order to secure an adequate oncological safety margin. Autologous flaps or artifact implants are commonly used when performing a replacement for a defect in the breast during BCS. Oxidized regenerated cellulose (ORC) is composed primarily of vegetable nitrocellulose and was originally developed as a styptic for surgery. We expected that the ORC would help induce granulation and fibrous tissue with reactive tissue fluid, and finally ORC would prevent adhesion between skin and pectoralis major muscle. In this study, we focused on short-term cosmetic outcomes after volume replacement with ORC after BCS.

Materials and Methods: Inclusion criteria of this study were the patients with early breast cancer indicated BCS that did not required breast reconstruction, or the patients who did not wish to undergo breast reconstruction with autologous flaps after BCS. We evaluated the cosmetic outcome of volume replacement with ORC after BCS, and also examined factors that may have influenced the results. The cosmetic outcomes of these patients were evaluated using scores based on the criteria of the Japan Breast Cancer Society.

Results: Ninety-four patients who underwent this procedure between January 2010 and August 2012 were reviewed. We evaluated cosmetic scores with regards to several clinical factors and the occurrence of complications after this procedure. The mean score of the cosmetic outcome of all patients was 9.5 points out of 12 points. Thirty-seven patients were categorized as “Excellent”, 34 were “Good”, 22 were “Fair”, and 1 was “Poor”. Patient age, body mass index, weight of the specimen, and ORC amount were not significantly different between patients with favorable cosmetic scores and those without.

Table 1. Univariate analyses of clinical factors according to the cosmetic outcome E/G* (n = 71)F/P# (n = 23)P valueAge52.5±12.656.0±10.30.23Body mass index22.0±3.723.3±4.10.15Specimen weight54.0±23.961.4±39.10.27ORC amount$3.2±1.23.2±1.20.95Values are expressed as the mean±SD. *Categorized as “Excellent” and “Good”. #Categorized as “Fair” and “Poor”. $ORC amount used for volume replacement.

However, the weight of the removed specimen was slightly higher in patients with an unfavorable cosmetic score. Although acute dermatitis and eczema was observed in 15% and 3% of patients, all of them were improved with conservative treatment. Cosmetic scores were significantly higher in patients without complications than in patients with complications.

Table 2. Cosmetic scores between patients with and without acute complications Cosmetic scores (mean±SD)P valusWithout9.8±2.00.003With8.0±2.4 

Conclusions: ORC replacement after BCS is a simple and reliable procedure. The selection of indication and prevention of complications are important for obtaining a better cosmetic outcome. To our knowledge, this is the first report to cosmetically evaluate a relatively large number of patients that have undergone ORC replacement after BCS.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-19-06.

[Relationships between the degree of lesion and that of vocal dysfunction in vocal fold polyp]

Relationships between the degree of lesion and that of vocal dysfunction were investigated in 122 cases of vocal fold polyp. A normalized size of polyps and glottic gap were correlated to the results of phonatory ability tests, stroboscopic investigations, acoustic analyses, and perceptual evaluations. There was no significant correlation between the size and the gap. The size of polyp was negatively correlated to fundamental frequency, whereas it was positively correlated to roughness of voice, asymmetry of vocal fold vibration, irregularity of vocal fold vibration, pitch perturbation quotient, amplitude perturbation quotient, and normalized noise energy. The glottic gap showed negative correlations to maximum phonation time and sound pressure level, and positive correlations to mean airflow rate and fundamental frequency.

Difficulty in high-pitched phonation by laryngeal trauma

We treated a case of laryngeal trauma in which difficulty in high-pitched phonation was the main feature of a voice problem. We emphasize the importance of phonatory function tests in determining the mechanism of voice disorders and in monitoring the effects of treatment. Physical examination, phonatory function tests, computed tomographic scan, and electromyogram disclosed that the voice problem was caused by a fracture of the thyroid cartilage and its fixation against the cricoid cartilage. An open reduction yielded recovery of the phonatory function.

Conservation, restoration and rehabilitation of voice in treating patients with carcinoma of the larynx. A 10-year review of 244 patients

We reviewed clinical records of 244 patients with carcinoma of the larynx treated during the 10 years from 1971 to 1980 in the Department of Otolaryngology, Kurume University Hospital. Of the 244 patients, 111 patients (45.5%) were treated with their voice conserved and 133 underwent total laryngectomy. In the latter, information on the modality of speech communication was obtained from 73 patients. Forty-nine (67%) of these 73 patients was able to speak by some means but the remaining 24 (33%) had no means to speak.

Trauma of the larynx and cervical trachea. A 10-year review of 51 patients

Trauma of the larynx and trachea is not a common condition. But once it happens, the management is not simple. This condition has been calling attention of physicians also because iatrogenic traumas have been increasing. In the 10-year period from 1971 to 1980, 51 patients with trauma of the larynx and/or the cervical trachea were treated in the Department of Otolaryngology, Kurume University Hospital. The purpose of this paper is to review these patients and to discuss the treatment of this difficult condition.