Original Articles CLINICAL STUDY OF ACUTE HEMORRHAGIC COLITIS ASSOCIATED WITH ANTIBIOTIC THERAPY I. CLINICAL PICTURES AND FECAL BACTERIAL FLORA Koichi
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1 Original Articles CLINICAL STUDY OF ACUTE HEMORRHAGIC COLITIS ASSOCIATED WITH ANTIBIOTIC THERAPY I. CLINICAL PICTURES AND FECAL BACTERIAL FLORA Koichi SUZUKI, Kazuhiro OBI, Tetsuji KITAHORA, Akira YOKOTA, Miwako MUKAI and Tadayoshi MORI (Okura National Hospital, Tokyo) Acute hemorrhagic colitis developing after the administration of oral synthetic penicillin has been paid attention as antibiotic-induced colitis in Japan. The authors have experienced 29 cases since Antibiotics causing this disease were ABPC in 20 cases, AMPC in 2, ACPC in 1, SBPC in 1, CEX in 3, LM in 1, etc. These drugs were administered orally for a short period of 1-5 days. The onset of the disease was characterized by abdominal pain, diarrhea developing relatively suddenly followed a little later by tomato juice-like bloody diarrhea. Light fever was observed in 14 cases (48%). The location of inflammatory lesion was confirmed by emergency endoscopy in 14 cases, It was found more proximal to the descending colon in 8 cases, and more proximal to the sigmoid in 6 cases. Mucosal edema and bleeding were also observed. In addition to this, longitudinal linear redness and narrowing of the lumen caused by dark red swelling of mucosa were observed in approximately 70% of the cases. Histologically, hemorrhage into lamina propria mucosae was prominent, inflammatory cell infiltration was relatively mild and eosinophilic infiltration was marked. Neither ulcer formation nor pseudomembranous plaque were observed. In order to investigate the cause of the colitis, authors performed a quantitative analysis of aerobic and anaerobic bacterial flora in 12 cases. The total number of bacteria in 1g of bloody feces was decreased to log 7-9 cells and the value of log (anaerobic bacterial number per gram / aerobic bacterial number per gram) was less than 1.1 in most cases which was generally about 2 in healthy adults. Klebsiella oxytoca was observed in 9 cases (75%), the number of which was log /g, and clostridin difficile was not detected at all in any case. The clinical and endoscopic pictures of the present disease was very similar to that of transient type of ischemic colitis, and it was concluded that the cause of antibiotics-induced hemorrhagic colitis might be different from that of pseudomembranous colitis.
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5 Table 3 Endoscopic findings
6 (医 療 第37巻 Fig. 1 第8号) Colonoscopic appearance of ABPC induced colitis 1/2 day after the onset showing narrowing of the lumen with markedly edematous reddish mucosa. Fig. 3 Barium and Fig. 2 Longitudinal anal side reddish of the lesion luminal seen enema showing irregularity narrowing colon. at narrowing. Fig. 4 例 も検 出 され て い ない. Histological findings specimen:extensive 考 the of transverse 案 are seen. not prominent. of biopsy mucosal Inflammatory bleeding change is (HE ~40) 腸 内細 菌叢 が 何 らか の 原 因 に よ り質 的 あ るい は量 的 に 変 化 す る こと に よ り, 下 痢 や 腸 炎 が 惹 起 され る こ と な く な つ た. は 日常 臨 床上 し ば しば遭 遇 す る現 象 で あ る. しか し腸 る も の と し て, 内 細 菌が どの よ うに変 化 し, どの よ うな 機序 に よ り腸 い る リ ン コ マ イ シ ンお よ び ク リ ン ダ マ イ シ ン に よ る も 粘膜 に病 的状 態 を ひ きお こす の か は一 部 の疾 患 での み の が あ げ られ る. 明 らか に され て い る にす ぎな い. 1950年 代 に 主 と し シ ンの副 作 用 と して偽 膜 性 腸 炎 が 起 る こ とが 報告 され て 病 院 内 で 発 生 した ブ ドウ球 菌 性腸 炎 は 菌 交 代 症 の て 以 来, 結 果Staphylococcus ハ ム ス タ ー に お け る リン コマ イ シ ンに よ る実 験 的腸 炎 enterotoxinに aureusの 増 殖, その 産 生 す る よ る, 時 に 偽 膜 まで 形 成 す る比 較 的 更 に その 発 症 機 序 が 明 らか に され つ つ あ 近 年 偽 膜 性(大)腸 1970年Benner2)に よ リ リン コ マ イ 多 くの 報 告 が 相 次 ぎ, 特 に1968年Small3)の 作 成 の 成 績 と併 せ, Rifkinら4), 激 しい粘 膜 病 変 で あ る こ とが 明 らか に され た1) 患 者 糞 便 中 のClostridium 年 代 にな り抗 ブ ドウ球 菌 剤(ペ ニ シ リン, カ ナ マ イ シ stridium difficileが ンな ど)が 登 場 す るに 及 ん で現 在 で は ほ とん どみ られ 炎 と して注 目 され て toxinの Bartlettら5)に よる 発 見 に よ り, Clo- 一 躍 注 目 さ れ る よ う に な つ た. 一 方 本 邦 に お い て 報 告 の 多 い 合 成 ペ ニ シ リ ン -759-
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8 Am. J. Gastroenterol., 54, 55, ) Small, J. D.:Fatal enterocolitis in hamsters given lincomyicin hydrochloride. Lab. Anim. Care, 18, 411, ) Rifkin, G. D. et al.:antibiotic-induced colitis. Implication of a toxin neuralized by Clostridium sordellii antitoxin. Lancet, 2, 1103, ) Bartlett, J. G. et al.:antibiotic-associated pseudomembranous colitis due to toxinproducing clostridia. N. Engl. J. Med., 298, 531, 1978
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CHEMOTHERAPY Fig. 1 Chemical structure of carumonam Disodium(+)-(Z)-CCE1-(2-amino-4-thiazoly1)-2-[[(2S, -(carbamoyloxymethyl)-4-oxo-1-sulfonato-3-azetidinyll -2-oxoethylidene] amino] oxy] acetate 3S)-2
coccus aureus Corynebacterium sp, Haemophilus parainfluenzae Klebsiella pneumoniae Pseudornonas aeruginosa Pseudomonas sp., Xanthomonas maltophilia, F
VOL.43 S-1 coccus aureus Corynebacterium sp, Haemophilus parainfluenzae Klebsiella pneumoniae Pseudornonas aeruginosa Pseudomonas sp., Xanthomonas maltophilia, Flavobacter- Table 1. Concentration of grepafloxacin
1) University Group Diabetes Program: A study of hypoglycemic agents on vascular complica- in patients with adult-onset tions diabetes. I. Design, methods and baseline results. Diabetes 19 (suppl. 2):
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The purpose of this study is to clarify a process that Awa dance developed into tourist resources and the factors that it spread out in all over Japan. Consideration was made with the memory magazines,
;~ (Summary) The Study on the Effects of Foot Bathing on Urination Kumiko Toyoda School of Human Nursing, University of Shiga Prefecture Background Foot bathing is one of the important nursing care for
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The Effect of the Circumferential Temperature Change on the Change in the Strain Energy of Carbon Steel during the Rotatory Bending Fatigue Test by Ch
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2007 18 12 2 3 30 1998 16.2 10 10 1 2008 1 44.5 41.2 39.6 6.0 2.2 1819 Bostock hay fever 4 1964 5 2008 15,673 1 1998 2008 17 300 6 10 23.4 26.5 15.4 2
30 2008 1,172 30 2008 39.6 3 1.5 2008 5 Pollen allergy due to Japanese cedar pollen and preventive measures by Tochigi Prefectural Government Abstract TAKAISHI Masaki, AOYAGI Tatsuya, MASUDA Takashi and
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VOL. 36 S-3 CHEMOTHERAPY 437
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Experimental and Clinical Studies of Pregnant Hypertension Takashi SHIMAZU Department of Obstetrics and Gynecology, Osaka City University Medical Scho
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Table 1 Antibacterial spectra of CPM and other antimicrobials against anaerobes Fig. 1 In vitro activity of CPM and other antibiotics against B. fragilis (136 strains) Fig. 2 In vitro activity of CPM and
社会技術論文集
STS Studies on Kanemi-Yusho Case with Special Interests on the Accident Investigation 1 1 M.Sc. (E-mail:tnakaji@plum.ocn.ne.jp) 1968 PCB 1. 2003 15 5 23 9;37 1900 2003 33 2 2 BSE 3 8; 14 2001 9 BSE 1 BSE
Fig. 1 Chemical structure of TE-031 Code number: TE-031 Chemical name: (-) (3R, 4S, 5S, 6R, 7R, 9R, 11R, 12R, 13S, 14R)-4-[(2, 6-dideoxy-3-C-methyl-3-
Fig. 1 Chemical structure of TE-031 Code number: TE-031 Chemical name: (-) (3R, 4S, 5S, 6R, 7R, 9R, 11R, 12R, 13S, 14R)-4-[(2, 6-dideoxy-3-C-methyl-3-O-methyl-a-L-ribo-hexopyranosyl) oxy]-14-ethyl-12,
Table 1 Sensitivity distribution of clinical isolates 1. Escherichia coli Inoculum size: 106cells/ml 2. Klebsiella pneumoniae 3. Enterobacter cloacae 4. Serratia marcescens Inoculum size: 106cells/nil
CHEMOTHERAPY 34 T-2588の APR.1986 嫌 気 性 菌 に 対す る抗 菌 作 用 に つ い て 沢 赫 代 神 野 英 毅 青 木 誠 小 林 と よ子 渡 辺 邦 友 上 野 一 恵 岐阜大学医学部附属嫌気性菌実験施設 新 し く 開 発 さ れ た 経 口 用 エ ス テ ル 型 セ フ ェ ム 系 抗 生 剤T-2588の 口 剤 で あ るcephalexin(CEX),cefaclor(CCL)
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Review The Secret to Healthy Long Life Decrease in Oxidative and Mental Stress My motto is Health is not all. But nothing can be done without health. Health is the most important requisite for all human
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ON A FEW INFLUENCES OF THE DENTAL CARIES IN THE ELEMENTARY SCHOOL PUPIL BY Teruko KASAKURA, Naonobu IWAI, Sachio TAKADA Department of Hygiene, Nippon Dental College (Director: Prof. T. Niwa) The relationship
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A case of no-reflow phenomenon during PCI to LIMA graft Iwatsuki-Minami hospital, Saitama, Japan Koichi Sano, Masaki Tsukagoshi, Yasunari Ueno, Seiichi Fukuda, Takayoshi Sato, Yasuyuki Maruyama 77 y.o.
Key words: Neonate, Intestinal flora, Infection, Bifidobacterium
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CHEMOTHERAPY Fig. 1 Chemical structure of CXM-AX
Fig. 1 Chemical structure of CXM-AX NOV. 1986 Fig. 2 Sensitivity distribution of clinical isolates organisms (106 cells/ml) a Smurcus 27 strains d) P.m irabilis 15 strains b Ecol i 27 strains 111.morganii
DISTRIBUTION OF NEUROPEPTIDES IN THE INFERIOR NASAL TURBINATE MUCOSA OF PATIENTS WITH ALLERGIC RHINITIS KAZUHIRO YAMAMOTO. M.D. Department of Otolaryngology, School of Medicine, Kitasato University, Sagamihara
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Title 近江湖北の神事をめぐる心理臨床学的研究 Author(s) 井上, 明美 Citation 京都大学大学院教育学研究科紀要 (2009), 55: 267-279 Issue Date 2009-03-31 URL http://hdl.handle.net/2433/72722 Right Type Departmental Bulletin Paper Textversion publisher
b) Gram-negative bacteria Fig. 2 Sensitivity distribution of clinical isolates : E. coli Fig. 3 Sensitivity distribution of clinical isolates : Pseudomonas Fig. 1 Sensitivity distribution of clinical isolates
220 28;29) 30 35) 26;27) % 8.0% 9 36) 8) 14) 37) O O 13 2 E S % % 2 6 1fl 2fl 3fl 3 4
Vol. 12 No. 2 2002 219 239 Λ1 Λ1 729 1 2 29 4 3 4 5 1) 2) 3) 4 6) 7 27) Λ1 701-0193 288 219 220 28;29) 30 35) 26;27) 0 6 7 12 13 18 59.9% 8.0% 9 36) 8) 14) 37) 1 1 1 13 6 7 O O 13 2 E S 1 1 17 0 6 1 585
Mechanism of painful breast induced by cold stimulus Yoshinori ITOH (Nagoya) Dept. of Physiol., Nagoya Univ, Sch, of Med., Nagoya, Japan Abstract Cold colic pain response was first mentioned in Kinkiyoryaku,
Key words: Antibodies to Leptospira, Tokyo, Uveitis
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Fig. 1 Chemical structure of KW-1070
Fig. 1 Chemical structure of KW-1070 Fig. 2 Sensitivity distribution of clinical isolates Fig. 4 Sensitivity distribution of clinical isolates Fig. 3 Sensitivity distribution of clinical isolates Fig.
Authors' Abstract It in known that the method of feeding powder into split cell affects the adhesion forces of powder beds, especially in fine particle powders. But the effect of the agglomeration phenomenon