Japanese pharmacopoeia prescribes a crude drug, Uncaria hook, or the hook-like structures of Uncaria rhynchophylla (Miq.) Jacks, U. sinensis (Oliv.) Havil., and U. macrophylla Wall., while Chinese pharmacopoeia prescribes the hooks with attached stems of above3species, in addition to2other species of Uncaria hook; U. hirsuta Havil. and U. sessilifructus Roxb (all in the Rubiaceae family). Our herbological study has found that the botanical origin was Uncaria rhynchophylla before the Ming Dynasty, and that the part used was not the hook itself, but the plant's bark till the early Ming Dynasty. Use of the hooks with stems began in the late Ming Dynasty. On the other hand, in Japan, the hooks themselves have been mainly collected from wild U. rhynchophylla plants growing in southern warm-temperate zone of Japan, for use in Kampo medicines. We considered this differing Japanese custom was influenced by the descriptions in the Ben Cao Gan Mu (1596)written in the Ming dynasty by Li Si Chen, which state that the hook itself had medicinally sharp power. And we conclude that use of Uncaria bark alone is reasonable for prescriptions which originated before the early Ming dynasty, such as chotosan.
Unit ; Chinese People ; Japanese language ; Within ; Hook

The crude Chinese drug “Uncaria hook” is a hook, or a twig with an attached hook of Uncaria plants seen in today's Chinese and Japanese medicinal markets. However, through herbological studies we found that the botanical origin of Uncaria hook was Uncaria rhynchophylla (Miq.) Miq., and that until the middle of Ming Dynasty in ancient China, the medicinal part used was the twig bark, not the hook itself, and use of the twig with hook was begun in the later Ming Dynasty. This change in practice seems to have been influenced by herbal descriptions written in the Ming Dynasty. Some of these stated that the medical effect of hooks was stronger than that of the bark.To determine the appropriate medicinal part of this crude drug in terms of chemical quality, we analyzed the alkaloid contents of Uncaria rhynchophylla bark, hooks, and twigs collected in Japan. Our result showed that the alkaloid content of the bark was higher than that of the twigs and hooks. Rhynchophylline and hirsutine, the alkaloid contained in Uncaria hook, were reported to improve memory learning and to cure hypertension, respectively. Since the alkaloid content profile of the bark was different from that of the hook, a question arose as to whether the medicinal properties of the part commonly used as “Uncaria hook” meet the requirement of the crude drug. Further pharmacological study is expected.
Chinese People ; Alkaloids ; Within ; Hook ; Pharmaceutical Preparations

STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the oncological outcomes, including distant relapse, after en bloc spondylectomy (EBS) for spinal metastases in patients with a minimum of 2-year follow-up. OVERVIEW OF LITERATURE: Although EBS has been reported to be locally curative and extend survival in select patients with spinal metastases, detailed reports regarding the control of distant relapse after EBS are lacking. METHODS: We conducted a retrospective review of 18 consecutive patients (median age at EBS, 62 years; range, 40–77 years) who underwent EBS for spinal metastases between 1991 and 2015. The primary cancer sites included the kidney (n=7), thyroid (n=4), liver (n=3), and other locations (n=4). Survival rates were estimated using the Kaplan–Meier method, and groups were compared using the log-rank method. RESULTS: The median operative time and intraoperative blood loss were 767.5 minutes and 2,375 g, respectively. Twelve patients (66.7%) experienced perioperative complications. Five patients (27.8%) experienced local recurrence of the tumor at a median of 12.5 months after EBS, four of which had a positive resection margin status. Thirteen patients (72.2%) experienced distant relapse at a median of 21 months after EBS. The estimated median survival period after distant relapse was 20 months (95% confidence interval, 0.71–39.29 months). No association was found between resection margin status and distant relapse. Overall, the 2-year, 5-year, and 10-year survival rates after EBS were 72.2%, 48.8%, and 27.1%, respectively. Importantly, the era in which EBS was performed did not impact the oncological outcomes. CONCLUSIONS: Our results suggest that EBS by itself, even if margin-free, cannot prevent further dissemination, which occurred in >70% of patients at a median of 21 months after EBS. These results should be considered and conveyed to patients for clinical decision-making.
Clinical Decision-Making ; Follow-Up Studies ; Humans ; Kidney ; Liver ; Methods ; Neoplasm Metastasis ; Operative Time ; Recurrence ; Retrospective Studies ; Spine ; Survival Rate ; Thyroid Gland

Transcatheter arterial embolization using N-butyl-2-cyanoacrylate (NBCA) for gastrointestinal arterial bleeding enables higher cessation rate and lower recurrent bleeding rate compared with conventional embolic materials including gelatin sponge, metallic coil, and polyvinyl alcohol (PVA) particle. Glue embolization is particularly effective in patients with coagulopathy. Even in the lower gastrointestinal tract, ischemic bowel complications by glue embolization are comparable to other agents. Glue embolization is also effective for arterial esophageal bleeding without any serious ischemic complications although the anatomy of the esophageal artery is complex and varied. For bleeding after abdominal surgery such as pancreaticoduodenectomy or hepatic lobectomy, interventional radiologists should be careful with indicating glue embolization because the presence of fewer collateral vessels can easily result in serious ischemic complications. Modified glue such as Glubran 2 (NBCA associated with methacryloxyfulfolane) can reduce the risk of ischemic complication due to its less thermal reaction, but the outcomes seem unsatisfactory.
Adhesives ; Arteries ; Cyanoacrylates ; Embolization, Therapeutic ; Enbucrilate ; Gastrointestinal Hemorrhage ; Gelatin ; Hemorrhage ; Humans ; Lower Gastrointestinal Tract ; Pancreaticoduodenectomy ; Polyvinyl Alcohol ; Porifera