ABSTRACT-To clarify the contractile mechanism of Dai-kenchu-to, the effects of hydroxy b -sanshool (an ingredient of Zanthoxylum fruit), Zanthoxylum fruit (a constituent herb of Dai-kenchu-to) and Daikenchu-to were studied in mucosa-free longitudinal muscle of guinea pig ileum. Hydroxy b -sanshool at 10 -7 -10 -5 g/ ml induced dose-related contractions accompanied by autonomous contraction and produced an initial contraction at a concentration of 10 -4 g/ml or more. The contraction induced by hydroxy b -sanshool (10 -5 g/ ml) was significantly inhibited by tetrodotoxin or the capsaicin-receptor antagonist capsazepine. Although atropine or the substance P antagonist spantide tended to inhibit the contraction, a combination of atropine and spantide almost abolished the contraction by hydroxy b-sanshool. The P2-purinoceptor antagonist pyridoxal-phosphate-6-azophenyl-2',4'-disulphonic acid did not affect hydroxy b-sanshool-induced contraction in the presence or absence of spantide. The tonic contractions by Zanthoxylum fruit (2´10 -4 g/ml) and Dai-kenchu-to (10 -3 g/ml) were significantly inhibited or tended to be inhibited by atropine, spantide, tetrodotoxin or capsazepine and were remarkably suppressed by the combination of atropine and spantide. These results suggested that acetylcholine release from intrinsic cholinergic nerves and tachykinins from sensory neurons are involved in the contractions induced by hydroxy b-sanshool and that tachykinins may be involved in the atropine-resistant contraction by Dai-kenchu-to.Keywords: Dai-kenchu-to, Zanthoxylum fruit, Hydroxy b-sanshool, Intestinal motility, Tachykinin Dai-kenchu-to (Da-Jian-Zhong-Tang in Chinese) is a traditional Chinese herbal medicine, called Kampo medicine in Japan, and is a mixture of Zanthoxylum fruit, ginseng, dried ginger root and malt sugar. This formula is known for clinical effects on intestinal obstruction subsequent to laparotomy (1, 2). In vivo studies have demonstrated that Dai-kenchu-to enhanced gastrointestinal motility in dogs and rabbits (2, 3), and prevented intestinal adhesion in rats (4). In experiments using isolated intestines, Daikenchu-to induced contractions in rabbit jejunum, guinea pig ileum and colon, and relaxed guinea pig gastric body (5 -8). These reports indicated that Zanthoxylum fruit induces contraction; however, the other constituent herbs had no significant contractile effect on the isolated intestine. In guinea pig ileum and colon, contractions due to Dai-kenchu-to and Zanthoxylum fruit are mediated by acetylcholine release from the ends of cholinergic nerves, and 5-HT4 receptors are involved (7,8). In addition, since we also noted that a mucosa-free preparation resists the contractile response to atropine (8), it was suggested that other neurotransmitters are involved in the contractile effect of Dai-kenchu-to.Hydroxy b-sanshool is considered to be one of the active compounds involved in inducing contraction by Zanthoxylum fruit (9, 10). It was reported that the contractile effect is due to the release of acetylch...

A 57-year-old woman with hypertension, mixed mitral valve disease, and atrial fibrillation was admitted to our hospital because of abdominal pain continuing for several hours. On the following day, colonoscopy was performed, and diffuse yellow-white pseudomembranous changes were seen in the right hemicolon, but there were no abnormal findings in the left hemicolon; 24 h after onset, a diagnosis of superior mesenteric arterial embolism was made on the computed tomography (CT) scan findings. Abdominal angiography was performed and showed complete occlusion of the superior mesenteric artery (SMA). Then conservative treatment, using per-catheteric thrombus aspiration, was done, followed by intraarterial injection of tissue type plasminogen activator. After the thrombo-aspiration, the filling deficit of the main artery had disappeared, and the branches on the right side were clearly delineated. After the treatment, the symptoms such as abdominal pain and diarrhea improved accordingly. She was discharged from the hospital 27 days later. Our case suggests that trans-catheter thrombo-aspiration is a possible alternative to open embolectomy for some cases of SMA embolism more than 10 h post-onset.

No abstract