Traditional medicines based on natural raw materials such as plants, animals , and minerals have been used to treat various diseases in most countries worldwide and especially in East Asia. Traditional Mongolian medicine, which is thought to be derived from Tibetan traditional medicine and its theories, has developed into its current forms. Similarly, Kampo medicine (traditional Japanese medicine), the theories for which come from traditional Chinese medicine, is the source of many popular and accessible drugs in Japan. These two traditional medicines have in many aspects in common, but there also are a few notable differences. In Mongolia, traditional medical doctors deal with Mongolian and Tibetan herbs, together with other components. The doctor prepares the best prescription for the patient based on their individual condition. Additionally, a few temples provide traditional medicines. On the other hand, in Kampo medicine in Japan, some pharmaceutical companies produce and sell packed Kampo formulae of crude drugs as ready-made products (Kampo products). Many medical doctors identify the patient’s disease and prescribe packed Kampo products, alongside Western medicines. Although less common, some doctors or pharmacists prepares original Kampo prescriptions to match the patient’s conditions. Both Mongolian and Japanese medicines have many merits and are used by many people in theirrespective countries. This report reviews Kampo medicines the direction of future research on theirmechanisms of action. Approximately 300 Kampo formulae are sold in pharmacies and drug stores. Many of them are combinations of two or more crude drugs, and although some contain a single crude drug, these are infrequent in Kampo medicine. The quality of each crude drug in Kampo formulae is subject to regulation. Officially, 276 crude drugs and some their formulae are listed in the Japanese Pharmacopoeia (JP) (16th edition, 2011). For example, “GLYCYRRHIZAE RADIX” is an important crude drug that is an element of about 70% of Kampo medicines. The JP entry for this crude drug lists: the plant sources (Glycyrrhiza uralensis and glabra), parts for medical use (root and stolon), the required amount of glycyrrhizin (one of the main constituents), methods for identification of this plant, and scientific sources for constituents, and pharmacological activities, among other details. Some Kampo formulae are considered as evidence-based medicines. “Syoseiryuto” is a well known Kampo formula for allergy of the nose, and it has established scientific data. In addition, clinical guideline recommends using this Kampo formula for treating allergy. Syoseiryuto is a combination of 8 crude drugs, PINELLIAE TUBER, ZINGIBERIS PROCESSUM RHIZOMA, GLYCYRRHIZAE RADIX, CINNAMOMI CORTEX, SCHISANDRAE FRUCTUS, ASIASARI RADIX, PAEONIA RADIX, and EPHEDRAE HERBA. “The combination of crude drugs” is a common element between traditional Mongolian medicine and Kampo medicine. Such a combination is expected to produce a variety of clinical effects, and these may be the key for useful pharmacological effects. Therefore, it is possible to paraphrase these facts into synergistic effects produced by combination of two or more crude drugs. Researchers have revealed the constituents, biological activities, pharmacological activities, and clinical effects of each crude drug. However, the mechanisms of combination effects are rarely well understood. It is generally too difficult to analyze the complex system of traditional medicines, including chemical interactions, individual variations, and reactions within the body. The difficulties in understanding of those mechanisms are producing many opportunities for future scientists. Many different approaches will be needed in order to elucidate the synergistic effects of combinations of natural crude drugs, and this represents the frontier for researchers dealing with traditional medicines.

There are 56 private pharmaceutical universities (or universities with a pharmaceutical department) in Japan, or approximately three times as many national or public universities with a pharmaceutical department (17 universities). Presently, over 10,000 students a year enroll in these private universities, approximately eight times as many in national or public universities. Pharmaceutical programs in Japan have two main objectives: the education of future pharmacists, as well as scientists. All Japanese pharmacists are required to pass the national pharmaceutical examination and obtain a license for practice. To partake in the national examination, candidates must receive a diploma from a pharmaceutical department of a university. Therefore, private pharmaceutical universities produce the majority of the nation’s pharmacists, playing a central role in the Japanese medical care system.The diploma program to become a pharmacist takes 6 years, with the course of study including basic science (chemistry, biology, physics) and “cultural subjects” (second languages, philosophy, mathematics) in the first year, and “specialized subjects” including organic chemistry, biological chemistry, physiology, and pharmacology from the second year on. Pharmacognosy, as well as traditional medicines commonly used in Japan, such as Kampo or medicinal plants, also comprise a portion of the lectures students are required to take. In addition, approximately 20 lectures including experiment skills are required during the course of study for students to study scientific and pharmaceutical skills, which include introductions to synthesis of some medical drugs as well as animal testing. Because academic credit must be obtained for nearly all courses, approximately 10-30% of students either require a course repeat or drop out entirely up until the fourth year of the program. After students pass the “Objective-Structured Clinical Examination” at the end of their fourth year, students begin their practical experience at hospitals and pharmacies their fifth year. In the sixth year, students study for the national examination. Subsequently, graduates with specific knowledge and skills for working as pharmacists leave these universities and are depended on as specialists of pharmacy and drugs by the public.Education for future scientists (researchers) is another important objective of private pharmaceutical universities. Some universities include a program of study for pharmaceutical research skills over the course of 4 years. To become a researcher, students continue on to graduate school to study and conduct laboratory research in their particular specialty the 4 years following their 6 year pharmacist course, or a 2 plus 3 year course (after the 4-year undergraduate degree) for the doctorate program. Students graduating with a Ph.D have access to a large variety of job opportunities, including becoming researchers at pharmaceutical companies, universities, or pharmaceutical agencies, or professional pharmacists. These 6- and 4-year programs were initiated and adapted in 2006; prior to 2005, all university pharmaceutical programs were 4-year courses. One reason underlying this longer program is the increasing workload necessary of pharmacists, requiring more specific and clinical knowledge. The above-mentioned points are the positive aspects of the private pharmaceutical universities of Japan, which have provided many pharmacists to match the recent needs of the medical care system. On the other hand, some problems regarding this system have recently been brought to light, such as an excess production of pharmaceutical students, which may cause problems for students, universities, and the public.Due to this, continuous improvement of the programs at private pharmaceutical universities is required.

There are 56 private pharmaceutical universities (or universities with a pharmaceutical department) in Japan, or approximately three times as many national or public universities with a pharmaceutical department (17 universities). Presently, over 10,000 students a year enroll in these private universities, approximately eight times as many in national or public universities. Pharmaceutical programs in Japan have two main objectives: the education of future pharmacists, as well as scientists. All Japanese pharmacists are required to pass the national pharmaceutical examination and obtain a license for practice. To partake in the national examination, candidates must receive a diploma from a pharmaceutical department of a university. Therefore, private pharmaceutical universities produce the majority of the nation’s pharmacists, playing a central role in the Japanese medical care system.The diploma program to become a pharmacist takes 6 years, with the course of study including basic science (chemistry, biology, physics) and “cultural subjects” (second languages, philosophy, mathematics) in the first year, and “specialized subjects” including organic chemistry, biological chemistry, physiology, and pharmacology from the second year on. Pharmacognosy, as well as traditional medicines commonly used in Japan, such as Kampo or medicinal plants, also comprise a portion of the lectures students are required to take. In addition, approximately 20 lectures including experiment skills are required during the course of study for students to study scientific and pharmaceutical skills, which include introductions to synthesis of some medical drugs as well as animal testing. Because academic credit must be obtained for nearly all courses, approximately 10-30% of students either require a course repeat or drop out entirely up until the fourth year of the program. After students pass the “Objective-Structured Clinical Examination” at the end of their fourth year, students begin their practical experience at hospitals and pharmacies their fifth year. In the sixth year, students study for the national examination. Subsequently, graduates with specific knowledge and skills for working as pharmacists leave these universities and are depended on as specialists of pharmacy and drugs by the public.Education for future scientists (researchers) is another important objective of private pharmaceutical universities. Some universities include a program of study for pharmaceutical research skills over the course of 4 years. To become a researcher, students continue on to graduate school to study and conduct laboratory research in their particular specialty the 4 years following their 6 year pharmacist course, or a 2 plus 3 year course (after the 4-year undergraduate degree) for the doctorate program. Students graduating with a Ph.D have access to a large variety of job opportunities, including becoming researchers at pharmaceutical companies, universities, or pharmaceutical agencies, or professional pharmacists. These 6- and 4-year programs were initiated and adapted in 2006; prior to 2005, all university pharmaceutical programs were 4-year courses. One reason underlying this longer program is the increasing workload necessary of pharmacists, requiring more specific and clinical knowledge. The above-mentioned points are the positive aspects of the private pharmaceutical universities of Japan, which have provided many pharmacists to match the recent needs of the medical care system. On the other hand, some problems regarding this system have recently been brought to light, such as an excess production of pharmaceutical students, which may cause problems for students, universities, and the public.Due to this, continuous improvement of the programs at private pharmaceutical universities is required.

Traditional medicines based on natural raw materials such as plants, animals , and minerals have been used to treat various diseases in most countries worldwide and especially in East Asia. Traditional Mongolian medicine, which is thought to be derived from Tibetan traditional medicine and its theories, has developed into its current forms. Similarly, Kampo medicine (traditional Japanese medicine), the theories for which come from traditional Chinese medicine, is the source of many popular and accessible drugs in Japan.These two traditional medicines have in many aspects in common, but there also are a few notable differences.In Mongolia, traditional medical doctors deal with Mongolian and Tibetan herbs, together with other components. The doctor prepares the best prescription for the patient based on their individual condition. Additionally, a few temples provide traditional medicines.On the other hand, in Kampo medicine in Japan, some pharmaceutical companies produce and sell packed Kampo formulae of crude drugs as ready-made products (Kampo products). Many medical doctors identify the patient’s disease and prescribe packed Kampo products, alongside Western medicines. Although less common, some doctors or pharmacists prepares original Kampo prescriptions to match the patient’s conditions.Both Mongolian and Japanese medicines have many merits and are used by many people in theirrespective countries. This report reviews Kampo medicines the direction of future research on theirmechanisms of action.Approximately 300 Kampo formulae are sold in pharmacies and drug stores. Many of them arecombinations of two or more crude drugs, and although some contain a single crude drug, these are infrequent in Kampo medicine.The quality of each crude drug in Kampo formulae is subject to regulation. Officially, 276 crude drugs and some their formulae are listed in the Japanese Pharmacopoeia (JP) (16th edition, 2011). For example, “GLYCYRRHIZAE RADIX” is an important crude drug that is an element of about 70% of Kampo medicines. The JP entry for this crude drug lists: the plant sources (Glycyrrhiza uralensis and glabra), parts for medical use (root and stolon), the required amount of glycyrrhizin (one of the main constituents), methods for identification of this plant, and scientific sources for constituents, and pharmacological activities, among other details.Some Kampo formulae are considered as evidence-based medicines. “Syoseiryuto” is a well known Kampo formula for allergy of the nose, and it has established scientific data. In addition, clinical guideline recommends using this Kampo formula for treating allergy. Syoseiryuto is a combination of 8 crude drugs, PINELLIAE TUBER, ZINGIBERIS PROCESSUM RHIZOMA, GLYCYRRHIZAE RADIX, CINNAMOMI CORTEX, SCHISANDRAE FRUCTUS, ASIASARI RADIX, PAEONIA RADIX, and EPHEDRAE HERBA.“The combination of crude drugs” is a common element between traditional Mongolian medicine and Kampo medicine. Such a combination is expected to produce a variety of clinical effects, and these may be the key for useful pharmacological effects. Therefore, it is possible to paraphrase these factsinto synergistic effects produced by combination of two or more crude drugs.Researchers have revealed the constituents, biological activities, pharmacological activities, and clinicaleffects of each crude drug. However, the mechanisms of combination effects are rarely well understood.It is generally too difficult to analyze the complex system of traditional medicines, includingchemical interactions, individual variations, and reactions within the body.The difficulties in understanding of those mechanisms are producing many opportunities for future scientists.Many different approaches will be needed in order to elucidate the synergistic effects of combinationsof natural crude drugs, and this represents the frontier for researchers dealing with traditional medicines.

During the past five years, 141 cases of liver cirrohosis were hospitalized intoour clinic. The mean age of these patients was 57.8 years old, and the ratio of male to female was 2.8 to 1. HBs antigen was positive in 16 cases, and among the patients without HBs antigen 49 cases of heavy alcoholic drinker were found. Seventy patients with liver cirrhosis were dividedinto a compensatory group and a decompensatory group according to three clinical findings, ascites, hepatic encephalopathy and bleeding from gastrointestinal tract. It was suggested that five items of biochemical data for liver function were very important on discriminating these two groups. The five items were cholinesterase, indocyanine green test, albumin, prothrombin time and erythrocyte count.
Next, we studied clinical findings of eight patients with minute hepatocellular carcinoma hospitalized into our clinic during the past five years. About a definition of minute hepatocellular carcinoma, we have defined that the tumor size should be less than 3 cm in diameter. Six of these patients were male, and average age was 56.7 years old. Of these patients, five were complicated by liver cirrhosis, and only one revealed positive HBs antigen in serum. The serum alpha-fetoprotein level showed more than 400 ng/ml in three patients. And we have thought that ultrasonographic examination is most effective to diagnose minute hepatocellular carcinoma in various diagnostic imaging methods. Most of patients exhibited a decreased functional reserve in the liver, but six patients underwent hepatic resection. After operation, one patient died of acutehepatic insufficiency on the 8th day, and one died of the recurrence of tumor on the 11th month. Otherfour patients have been alive now.

Left heart bypass was performed with Bio Medicus Co.-made Bio-pump, a representative centrifugal pump. A vinyl chloride tube for the usual cardio-pulmonary bypass not treated with antithrombogenic material. was used in the bypass circuit. In the experiment, the mongreal adult dogs were divided into the systemic heparinized group and non-heparinized group and the bypass was performed for 6 hours. As a result, coagulation and fibrinolysis were more activated in the non-heparinized group than the other group. So, when this method is used clinically, a small quantity of heparin should be administered. Clinically, this approach was used as an adjunct in operation for 7 cases of thoracic aortic aneurysm. During left heart bypass, a small quantity of heparin (0.5-1.0mg/kg) was administered. A rise in FPA and FDP considered attributable to autotransfusion during the operation was noted. Distal perfusion could be performed fully and the amount of bleeding during and after operation was small, but 1 case each of acute renal failure and paraplegia as postoperative complication was encountered. Neither was considered due to left heart bypass; and, changes in respiratory system and hepato-renal function were considered within the tolerable range. These results have led us to believe that left heart bypass using Bio-pump is safe and useful as an adjunct in operation for thoracic aortic aneurysm and should be used positively in the future.

A 24-year-old woman had been injured in an automobile accident. The chest X-ray showed widening of the mediastinum and computed tomography showed mediastinal hematoma around the aortic arch. Aortic rupture was suspected, so we performed aortography, which revealed pseudoaneurysm of the descending aorta. Moreover, she also had splenic rupture and pelvic fracture. She underwent an emergency operation 4 hours after the accident. Medial tear of the descending aorta was replaced with a graft under temporary bypass without heparin. Simultaneously, splenectomy was performed. Her postoperative course was uneventful. We consider that temporary bypass without heparin is a useful method during repair of the descending aortic rupture due to trauma.

Abstract The genus Saxifraga, one of the largest genera of the Saxifragaceae family, comprises 540 species and is distributed widely in mountainous and rocky regions, with 12 species being found in Mongolia. Saxifraga spinulosa Adams is a perennial herbaceous plant common in mainland China, Russia, and Mongolia, inhabiting stony marginal terrain. The isolated compounds from Saxifraga spinulosa were screened for DPPH radical-scavenging activity, with Trolox as a positive control (IC₅₀ 23.3 µM). All the new glucosides exhibited potent activities (IC₅₀ 19.0–72.9 µM). A crude ex- tract of S. spinulosa has been reported to display the highest DPPH radical-scavenging activity among numerous Mongolian medicinal plants, which may now be attributed, at least in part, to the presence of the new flavonoid and galloyl group-containing isolated compounds.