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Therapeutic barium enema for bleeding colonic diverticula:Four case series and review of the literature

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World Journal of Gastroenterology 2008年第41期14卷 6413-6417页

作者： Jun-ichi Iwamoto Yuji Mizokami Koichi Shimokobe Takeshi Matsuoka Yasushi Matsuzaki Department of Gastroenterology Tokyo Medical University Kasumigaura Hospital Chuo 3-20-1 Ami Inashiki

The prevalence of diverticular diseases of the colon, including severe and persistent bleeding in Eastern countries, has increased in the last decades. The bleeding from colonic diverticula is the most common cause of acute lower gastrointestinal bleeding. Herein, we report four cases of severe and persistent bleeding of colonic diverticular disease that could be treated with a high concentration barium enema. These four cases showed a similar pattern of bleeding whose source could not be identified. Colonoscopy revealed fresh blood in the entire colon and many diverticula were noted throughout the colon. No active bleeding source was identified, but large adherent clots in some diverticula were noted. After endoscopic and angiographic therapies failed, therapeutic barium enema stopped the severe bleeding. These patients remained free of re-bleeding in the follow-up period (range 17-35 mo) after the therapy. We report the four case series of therapeutic barium enema and reviewed the literature pertinent to this procedure.

关键词：灌肠剂结肠炎盲管渗漏症状

Therapeutic efficacy of the Qing Dai in patients with intractable ulcerative colitis

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World Journal of Gastroenterology 2013年第17期19卷 2718-2722页

作者： Hideo Suzuki Tsuyoshi Kaneko Yuji Mizokami Toshiaki Narasaka Shinji Endo Hirofumi Matsui Akinori Yanaka Aki Hirayama Ichinosuke Hyodo Department of Gastroenterology Institute of Clinical Medicine University of Tsukuba Graduate School Center of Integrative Medicine Tsukuba University of Technology

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that may become intractable when treated with conventional medications such as aminosalicylates, corticosteroids, and azathioprine. The herbal medicine Qing Dai has traditionally been used in Chinese medicine to treat UC patients, but there is a lack of published data on the efficacy of Qing Dai in UC treatment. We report several cases of patients with intractable UC who take Qing Dai in a retrospective observational study. Furthermore, we explore the mechanisms of action of Qing Dai. Nine patients with active UC who received conventional medications but wished to receive Qing Dai as an alternative medication were included in our analysis. The UC severity level was determined based on the clinical activity index (CAI). Additionally, 5 of the 9 patients were endoscopically evaluated according to the Matts grading system. Each patient received 2 g/d of Qing Dai orally and continued taking other medications for UC as prescribed. Electron spin resonance was applied to explore the mechanisms of action of Qing Dai. After 4 mo of treatment with Qing Dai, the CAI score decreased from 8.3 ± 2.4 to 2.4 ± 3.4 (mean ± SD; P < 0.001). Similarly, the endoscopic Matts grade decreased from 3.4 ± 0.5 to 2.2 ± 0.8 (P = 0.02). Six of 7 patients who were on prednisolone upon enrollment in the study were able to discontinue this corticosteroid. Electron spin resonance revealed that Qing Dai possesses strong hydroxyl radical scavenging activity. Qing Dai showed significant clinical and endoscopic efficacy in patients who failed to respond to conventional medications. Scavenging of hydroxyl radicals appears to be a potential mechanism through which Qing Dai acts, but the significance of the scavenging ability of Qing Dai with respect to the anti-inflammatory effect in UC patients warrants further investigation.

关键词： Qing Dai Herbal medicine Ulcerative colitis Hydroxyl radical Electron spin resonance

Y chromosome microdeletion screening using a new molecular diagnostic method in 1030 Japanese males with infertility

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Asian Journal of Andrology 2020年第4期22卷 368-371页

作者： Masashi Iijima Kazuyoshi Shigehara Hideki Igarashi Koichi Kyono Yasuo Suzuki yuji Tsuji Yoshitomo Kobori Hideyuki Kobayashi Atsushi mizokami Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical ScienceKanazawa 920-8641Japan Kyono ART Clinic Sendai 980-0014Japan Kyono ART Clinic TakanawaTokyo 108-0074Japan Suzuki Lady's Hospital Kanazawa 921-8033Japan Ebisu Tsuji Clinic Tokyo 150-0021Japan Tenjin Tsuji Clinic Fukuoka 810-0001Japan Dokkyo Medical University Koshigaya Hospital Saitama 343-8555Japan Department of Urology Faculty of MedicineToho UniversityTokyo 143-8541Japan

The azoospermia factor(AZF)region is important for spermatogenesis,and deletions within these regions are a common cause of oligozoospermia and azoospermia.Although several studies have reported this cause,the present research,to the best of our knowledge,is the first large-scale study assessing this factor in Japan.In this study,1030 male patients with infertility who were examined for Y chromosome microdeletion using the polymerase chain reaction-reverse sequence-specific oligonucleotide(PCR-rSSO)method,a newly developed method for Y chromosome microdeletion screening,were included.The study enrolled 250 patients with severe oligospermia and 717 patients with azoospermia.Among the 1030 patients,4,4,10,and 52 had AZFa,AZFb,AZFb+c,and AZFc deletions,respectively.The sperm recovery rate(SRR)of microdissection testicular sperm extraction in patients with AZFc deletions was significantly higher than that in those without AZF deletions(60.0%vs 28.7%,P=0.04).In patients with gr/gr deletion,SRR was 18.7%,which was lower than that in those without gr/gr deletion,but was not statistically significant.In conclusion,our study showed that the frequency of Y chromosome microdeletion in male patients in Japan was similar to that reported in patients from other countries,and SRR was higher in patients with AZFc deletion.

关键词： azoospermia factor Japanese infertile men sperm recovery rate Y chromosome microdeletion

Small-bowel mucosal injuries in low-dose aspirin users with obscure gastrointestinal bleeding

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World Journal of Gastroenterology 2014年第36期20卷 13133-13138页

作者： Junichi Iwamoto Yuji Mizokami Yoshifumi Saito Koichi Shimokobe Akira Honda Tadashi Ikegami Yasushi Matsuzaki Department of Gastroenterology Tokyo Medical University Ibaraki Medical Center Ibaraki 300-0395 Japan Department of Gastroenterology University of Tsukuba Ibaraki 305-8576 Japan

AIM: To investigate the clinical differences between small intestinal injuries in low-dose aspirin(LDA) users and in non-steroidal anti-inflammatory drug(NSAID) users who were examined by capsule endoscopy(CE) for obscure gastrointestinal bleeding(OGIB). METHODS: A total of 181 patients who underwent CE for OGIB were included in this study. Based on clinical records, laboratory data such as hemoglobin levels, major symptoms, underlying diseases, the types and duration of LDA and NSAID use, and endoscopic characteristics of CE were reviewed.RESULTS: Out of a total of 45 cases of erosive lesions, 27 cases were taking LDA or NSAIDs(7 were on NSAIDs, 9 were on LDA alone, 9 were on LDA and thienopyridine, and 2 were on LDA and warfarin).The prevalence of ulcers or erosion during chronic use of LDA, LDA and the anti-platelet drug thienopyridine (clopidogrel or ticlopidine), and NSAIDs were 64.3%, 80.0%, and 75.0%, respectively. Erosive lesions were observed predominantly in chronic LDA users, while ulcerative lesions were detected mainly in NSAID users. However, concomitant use of thienopyridine such as clopidogrel with LDA increased the proportion of ulcers. The erosive lesions were located in the whole of the small intestine(jejunum and ileum), whereas ulcerative lesions were mainly observed in the ileum(P < 0.05). CONCLUSION: Our CE findings indicate that chronic LDA users and NSAID users show different types and locations of small-bowel mucosal injuries. The concomitant use of anti-platelet drugs with LDA tends to exacerbate the injuries from LDA-type to NSAID-type injuries.

关键词： Non-steroidal anti-inflammatory drugs Lowdose aspi