We reviewed our prior clinical and experimental studies about the effects of chotosan, a Kampo formula, on cerebrovascular disorders. A double-blind randomized controlled trial demonstrated that chotosan was effective on vascular dementia. Chotosan improved microcirculation and hemorheological factors in patients with asymptomatic cerebral infarction. This formula inhibited the elevation of blood pressure, protected endothelial function, and prolonged the life span of stroke-prone spontaneously hypertensive rats. The phenolic fraction of Uncaria sinensis (US), a main medicinal plant of chotosan, had endothelium-dependent relaxation effect, and its alkaloid fraction possessed endothelium-independent relaxation effect. It was revealed that US had neuroprotective effects on glutamate- and NO donor-induced neuronal death in cultured neurons. Chotosan and US had protective effects on delayed neuronal death after transient forebrain ischemia in gerbils, and enhanced superoxide anion and hydroxyl radical scavenging activities and catalase activity in the brain. All of these results suggest that chotosan has such multiple pharmacological actions as improving effect on microcirculation, protective effect on endothelial function, and neuroprotective effect, and this formula is useful for prevention of the development of cerebrovascular disorders.

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Hangekobokuto and Kososan are representative Kampo medicines for the treatment of autonomic abnormalities and are used for Ki stagnation with neurosis or depressive states. Since the targets of the treatment with these two Kampo medicines largely overlap, the differentiation between the precise indications for which each is used is difficult. In order to clarify the relationship between the treatment effects of Kampo medicines and the autonomic nervous system, we performed studies by binocular infrared video pupillography (Iriscorder® C-7364, Hamamatsu Photonics, Hamamatsu, Japan). This study was performed to determine whether an objective differentiation between Hangekobokuto and Kososan is possible based on the pupillary dynamics in terms of autonomic nerve function. A comparison between the observed states before and after the administration of Hangekobokuto has revealed that sympathetic nerve activity is inhibited in the group of patients belonging to the sympathetic nerve domination type. After the administration of Kososan, sympathetic nerve activity is stimulated in the group of patients belonging to the non-sympathetic nerve domination types. Thus, the regulatory actions of the Kampo medicines on the autonomic nervous system were confirmed. This method of using an Iriscorder® was useful for evaluating the treatment effects of Kampo medicines.

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Fifteen hot water extracts prepared from 8 plants representing 7 families used traditionally in malaria treatment in Kenya were screened for their in vivo antimalarial activity against chloroquine (CQ)-tolerant rodent malaria parasite Plasmodium berghei(strain NK65), in ICR mice. When used alone,Ficus sur leaf extract had 41% suppression of parasitemia relative to untreated controls (P= 0.002). Four plants,Albizia gummifera, Caesalpinia volkensii, Ekebergia capensis and Maytenus acuminata showed mild parasitaemia suppression ranging from 9-32%. Three plants,Ajuga remota, Azadirachta indica and Clerodendrum myricoides showed no activity at all. In combination with CQ, both F.sur leaf and stem bark extracts gave a 2-week longer survival of mice relative to the CQ-alone treated controls, although the 2 groups had comparable parasitaemia to the CQ controls before treatment. However, the combinations showed no significant reduction in parasite load. A. gummifera leaf extract/CQ combination had 2.3-fold decrease in mean parasitaemia (57%) and also prolonged the survival of mice by over 2 weeks, compared to CQ controls. The results of interactions of the 2 plants' extracts with CQ indicate a potentiation effect. We conclude that both F.sur and A. gummifera warrant further investigations to determine their potential as sources of antimalarial agents.

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Increasing evidence suggests that remnant-like lipoprotein particles cholesterol (RLP-C) is an independent cardiovascular disease (CVD) risk factor. High levels of RLP-C exhibit findings similar to those of "oketsu" syndrome on blood rheology studies and scanning electron micrographs. We measured levels of RLP-C in plasma samples and "oketsu" scores obtained in 199 randomly selected subjects. The coefficient of correlation between levels of RLP-C and "oketsu" score was highly significant (r=0.581, P<0.0001). This finding suggests that presence of excess RLP-C in the blood resembles closely "oketsu" syndrome which we have shown to be an independent risk factor for CVD.

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The effect of Goreisan enema on acute gastroenteritis of children was investigated. The subjects were three hundred thirty-six children presenting with vomiting caused by acute gastroenteritis who were among those with vomiting as their chief complaint. Goreisan(2.5g) was dissolved in 20 ml of warm physiological saline and given as an enema. The effective rate of Goreisan enema for all cases was 79%. There was a significant correlation between the number of times of vomiting before consultation and the effective rates of Goreisan enema (P<0.01). Goreisan enema is a simple treatment without causing pain in children. Therefore, Goreisan enema can be considered as an effective treatment for child's acute gastroenteritis because of its high effective rate without causing side effects.

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