• Title/Summary/Keyword: Hemorrhagic colitis

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Ulcerative Colitis Mimicking Acute Hemorrhagic Colitis (급성 출혈성 대장염으로 오인된 궤양성 대장염 1예)

  • Moon, Hee-Jung;Jang, Byung-Ik;Kim, Sung-Bum;Lee, Ho-Chan;Park, Jae-Hyun;Eun, Jong-Ryul;Kim, Tae-Nyeun
    • Journal of Yeungnam Medical Science
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    • v.25 no.2
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    • pp.182-186
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    • 2008
  • Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.

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Antibiotics-Associated Hemorrhagic Colitis Caused by Klebsiella oxytoca: Two Case Reports

  • Youn, Youngmin;Lee, Sang Won;Cho, Hyun-Hae;Park, Sanghui;Chung, Hae-Sun;Seo, Jeong Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.21 no.2
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    • pp.141-146
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    • 2018
  • Nowadays, Klebsiella oxytoca is described as a causative organism for antibiotic-associated hemorrhagic colitis (AAHC). Here we report two cases of pediatric AAHC, from which K. oxytoca was cultured after starting amoxicillin-clavulanate or amoxicillin treatment. The patients developed severe abdominal pain and a large amount of bloody diarrhea. K. oxytoca was obtained in intestinal fluid culture of a boy through the colonoscopy. On the other hand, colonic tissue culture and intestinal fluid culture were negative of the other patient. K. oxytoca was detected in stool culture when he was admitted. These cases showed characteristic endoscopic findings of segmental hemorrhagic colitis, and both boys recovered spontaneously within 2-3 days after they stopped taking the antibiotics. Therefore, in children who develop relatively large amount of bloody diarrhea after antibiotic treatment, we should consider AAHC caused by K. oxytoca.

The anti-oxidative and anti-inflammatory effect of Psoralea corylifolia on Ulcerative Colitis Induced by Dextran Sulfate Sodium in Mice

  • Ahn, Sang Hyun;Kim, Ki Bong
    • The Journal of Korean Medicine
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    • v.37 no.4
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    • pp.10-21
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    • 2016
  • Objectives: This study was to investigate the anti-oxidative and anti-inflammatory effect of Psoralea corylifolia water extract (PE) on ulcerative colitis which was induced by dextran sulfate sodium (DSS) in mice. Methods: Ulcerative colitis was induced by DSS in male BALB/c mice. The mice were divided into 3 groups. The control group (Ctrl) was not induced ulcerative colitis. The pathological group (CE) was induced the colitis. The experimental group (PT) was administered PE after inducing the colitis. The effects of the PE on ulcerative colitis were evaluated by morphological change in the colon tissue and cells, substance P production, activity of tumor necrosis factor $(TNF)-{\alpha}$ and nuclear factor $(NF)-{\kappa}B$, cyclooxygenase (COX)-2 production, and anti-oxidative activity. Results: In the PT group, PE alleviated hemorrhagic erosion in colon mucosa and infiltration of inflammatory cells in lamina propria mucosae. In the colon of the PT group, COX-2 production was inhibited via regulating the activity of $TNF-{\alpha}$ and $NF-{\kappa}B$ p65. PE also had an anti-oxidative effect via activating nuclear factor (erythroid-derived 2)-like 2 (Nrf2). Conclusions: In this study, we found the utility of treatment with PE and the potential of developing a medicine for ulcerative colitis by applying our results. Further investigations for the anti-inflammatory mechanism of PE may be needed.

A Study on the Treatment Effect of Dojeckjiyu-tang for Ulcerative Colitis (도적지유탕이 궤양성 대장염 유발 흰쥐에 미치는 영향)

  • 김승욱;임성우
    • The Journal of Korean Medicine
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    • v.23 no.3
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    • pp.200-210
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    • 2002
  • Objectives: Dojeckjiyu-tang has been used to treat Hwaseol & Jeokri. The object of this study is examination of the treatment effect of Dojeckjiyu-tang for ulcerative colitis of the mouse descending colon. Methods and Materials : Twenty-one rats were divided into 3 groups and treated as follows: the control group was untreated mice. The UCE group was ulcerative colitis elicited mice. The DJT group was Dojeckjiyu-tang treated mice after ulcerative colitis elicitation. The groups were examined with common morphology, paneth cells in intestinal crypt, absorptive cells and goblet cells in epithelium, cell division in mucose, COX-1 as mucosal protector, COX-2 (which appears to play an important role in inflammation), IL-2R-, ICMA-1-inducing cellular immuno-chainreaction, and the distribution of apoptotic cells. Results: 1. The morphology of colonic mucosa from UCE mice: the disappearance of epithelium and intestinal propria in hemorrhagic erosions were seen, but in the morphology of colonic mucosa from DJT-treated mice, the configuration of epithelium and intestinal propria were the same as normal. 2. The distribution of goblet cells and absorptive cells with microvilli in intestinal propria from UCE mice: a noticeable decrease of goblet cells and absorptive cells with microvilli were seen, but with the distribution of goblet cells and absorptive cells with microvilli in intestinal propria from DJT -treated mice, the configuration of goblet cells and absorptive cells with microvilli were the same as normal. 3. The immunohistochemical stain for BrdD in colonic mucosa and COX-1 in lamina propria from UCE mice: BrdU positive cells and COX-1 positive cells in the region of hemorrhagic erosion disappeared, but in the immunohistochemical stain for BrdU in colonic mucosa and COX-1 in lamina propria from DIT-treated mice, BrdU positive cells and COX-1 positive cells were seen. 4. The immunohistochemical stain for COX-2 in lamina propria, IL-2R-in lamina propria, intestinal propria and submucosa and ICMA-1 in intestinal propria and submucosa from DCE mice: a noticeable increase COX-2, IL-2R-, ICMA-1 positive cells were seen, but in the immunohistochemical stain for COX-2 in lamina propria, IL-2R-in lamina propria, intestinal propria and submucosa and ICMA-1 in intestinal propria and submucosa from DJT-treated mice, a numerical decrease of COX-2, IL-2R-, ICMA-1 positive cells was observed. 5. The distribution of apoptotic cells in epithelium and lamina propria from UCE mice: a noticeable increase of apoptotic cells in region of hemorrhagic erosion was seen, but in the distribution of apoptotic cells in epithelium and lamina propria from DJT-treated mice, a remarkable decrease of apoptotic cells was seen. Conclusions: According to the above results, Dojeckjiyu-tang has a moderate effect on ulcerative colitis in descending colon.

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The Anti-Inflammatory Effect of Lonicera Japonica-Glycyrrhiza Uralensis Decoction on Ulcerative Colitis Induced by DSS in Mice (항염증조절을 통한 금은화-감초 복합 추출물의 DSS 유도 궤양성 대장염 완화 효과)

  • Lee, Yeon Woo;Ahn, Sang Hyun;Kim, Ho Hyun;Kim, Kibong
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.3
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    • pp.16-25
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    • 2018
  • Objectives The purpose of this study is to investigate the anti-inflammatory effect of Lonicera Japonica-Glycyrrhiza Uralensis decoction extracts (LGE) on ulcerative colitis in children and adolescents. Methods Colitis was induced by DSS (Dextran Sulfate Sodium) in C57BL/6 mice. The sample mice were divided into group of four. The mice in the control group were not inflammation-induced. The control group was composed of untreated ulcerative colitis elicited mice. The mice in the experimental group were administered with Pentasa and another experimental group mice were treated with LGE after colitis elicitation. The effects on ulcerative colitis were evaluated by the morphological changes of colonic mucosa, decrease in the effect of pro-inflammatory cytokines ($TNF-{\alpha}$ and $NF-{\kappa}B$) and inflammatory cytokines (iNOS and COX-2) in the mucosa. Results LGE showed protective effects in DSS induced ulcerative colitis. LGE inhibited shortening of colon length and relieved the hemorrhagic erosion in colonic mucosa. LGE decreased pro-inflammatory cytokines ($TNF-{\alpha}$ and $NF-{\kappa}B$) and inflammatory cytokines (iNOS and COX-2). According to the GC/MS analysis, N-methyl pyrrolidone (NMP) was identified. Conclusions The result shows the clinical efficacy of LGE and demonstrates possible treatment options for ulcerative colitis. Further investigations for biological activity and chemical analysis of LGE will be needed.

The Anti-oxidative and Anti-inflammatory Effect of Lonicera Japonica on Ulcerative Colitis Induced by Dextran Sulfate Sodium in Mice (금은화 추출물의 항산화, 항염증 효과가 Dextran Sulfate Sodium으로 유도된 생쥐의 궤양성 대장염에 미치는 영향)

  • Cha, Ho Yeol;Jeong, A Ram;Cheon, Jin Hong;Ahn, Sang Hyun;Park, Sun Young;Kim, Ki Bong
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.3
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    • pp.54-64
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    • 2015
  • Objectives : This study was to investigate the anti-oxidative and anti-inflammatory effect of Lonicera japonica water extracts (LE) on Ulcerative Colitis Induced by DSS (Dextran Sulfate Sodium) in Mice. Methods : Colitis was induced by DSS in Balb/c mice. The sample group was divided into three. The mice in control group were not inflammation-induced. The pathological group was composed of untreated colitis elicited mice. The experimental group was administered Lonicera japonica water extracts (LE) after colitis elicitation. The effects on ulcerative colitis were evaluated the anti-oxidant effect, inhibition of COX-2 mRNA expression, the morphological change of colonic mucosa, decrease effect of HSP 70 and COX-2 in mucosa. Results : The SOD ability of LE was dose-dependently increased and the LPS-induced COX-2 mRNA expression of LE was dose-dependently decreased. LE showed the protective effects on DSS-induced experimental colitis. LE inhibited shortening of colon length, the hemorrhagic erosion in colonic mucosa. LE also showed the decrease effect for HSP70 and COX-2 in mucosa. Conclusions : The current results demonstrate the clinical utility of LE in traditional medicine and indicate the possible treatments for ulcerative colitis from natural products. Further investigations for exact mechanisms will be needed.

Mitigating Effect of Jageum-jung on Dextran Sulfate Sodium-induced Ulcerative Colitis through Anti-inflammatory Regulation (항염증조절을 통한 자금정의 DSS 유도 궤양성 대장염 완화 효과)

  • Choi, Jun-yong;Ahn, Sang-hyun;Shih, Yin-hao;Sa, Bok-suk;Kim, Ki-bong
    • The Journal of Internal Korean Medicine
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    • v.38 no.6
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    • pp.944-954
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    • 2017
  • Objectives: This study investigated the anti-inflammatory effects of Jageum-jung extract on Dextran sulfate sodium (DSS-induced) ulcerative colitis in mice. Methods: Ulcerative colitis was induced by DSS in Balb/C male mice. Ten mice were assigned to each of four groups: Ctrl (control), UE (ulcerative colitis-induced), PT (treated with pentasaccharide after induction of ulcerative colitis), and JT (treated with Jageum-jung extract after induction of ulcerative colitis). The effects of Jageum-jung extract were measured by restoration of the length of the intestine, degree of mucosal damage as seen with histochemistry, and changes of p-IkB, iNOS, COX-2, and caspase-3 determined by immunohistochemistry. Results: The recovered intestinal length of the JT group was longer than that of the UE group. In the colon mucosa of JT group, hemorrhagic lesions were reduced, and the mucus barrier was recovered. This group also showed inhibited production of inflammatory enzymes (iNOS, COX-2) through regulation of proinflammatory enzyme (NF-kB, p65) activity in the colon. In addition, caspase 3 activation induced apoptosis. By GC/MS analysis, azetidine was identified. Conclusions: This study confirmed the anti-inflammatory effects of jageum-jung extract, and suggests the possibility of using Jageum-jung extract to treat ulcerative colitis. Further experiments and research on the mechanism of Jageum-jung effects are needed.

Characterization and isolation of shiga toxin-producing Escherichia coli from Bovine feces and Carcass (소의 분변과 도체에서 shiga toxin-producing Escherichia coli의 분리와 특성)

  • Chae, Hee-Sun;Kim, Neung-Hee;Han, Hye-Jin;Son, Hong-Rak;Kim, Chang-Ki;Kim, Sun-Heung;Lee, Jung-Hark;Kim, Jong-Taek
    • Korean Journal of Veterinary Service
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    • v.32 no.3
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    • pp.241-249
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    • 2009
  • Shiga toxin (Stx)-producing Escherichia coli (STEC) strains can cause broad spectrum of human disease, including diarrhea, hemorrhagic colitis, and the life-threatening hemolytic uremic colitis (HUS). We examined 868 samples was taken from bovine feces and carcass from January to December 2008 in Seoul. Twenty two (9.5%) shiga toxin -producing Escherichia coli were isolated from the 230 of bovine feces, and two (0.31%) were isolated from the 638 of carcasses. Serotype of E. coli isolates were O157 (10, 41.6%), O26 (10, 41.6%), O111 (1, 4.2%) and UT (3, 12.6%). In PCR, the isolates displayed three different stx gene combination (stx1 [2, 8.4%]), stx2 [3, 12.6%] and stx1 and stx2 [19,87.5%]). The eaeA and hlyA gene were found in 11 (45.8%) of the 24 strains. Saa gene was present only one strains (4.2%). Toxin typing using reverse passive latex agglutination test showed the same result in VT 1. But it showed different result in VT 2. In antimicrobial susceptibility test, all isolates were sensitive to amikacin, amoxicillin/clavulanic acid, ciprofloxacin and colistin. Eighteen strains (75.0%) of 24 isolates showed the multi-resistant patterns with over 3 drugs. PFGE was performed after the genomic DNA of twenty four isolates was digested with Xba I. the 24 isolates showed 7 (A~G) PFGE type.

A Study of Clinical Manifestations of Gastrointestinal Symptoms in Children with Henoch-Schönlein Purpura (소아 Henoch-Schönlein Purpura 환아에서 위장관 증상 유무에 따른 임상 소견에 대한 연구)

  • Oh, Se-Whung;Choe, Jae-Hyung;Kim, Yong-Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.183-192
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    • 2006
  • Purpose: This study was undertaken to evaluate the factors correlated with the clinical course and outcome in patients of Henoch-Sch${\ddot{o}}$nlein Purpura. Methods: The medical records of 104 children diagnosed with Henoch-Sch${\ddot{o}}$nlein Purpura (HSP) from January 1996 to April 2006 were reviewed retrospectively. The patients were divided into two groups: patients with Gastrointestinal (GI) symptoms and those without GI symptoms. When there were joint, scrotum, and renal symptoms except for skin lesion in whole HSP, those patients were excluded. The history of acute infection, duration of admission, treatment requirement, recurrence of HSP, CBC, stool occult blood test, abdominal ultrasonographic findings and GI endoscopic findings were reviewed. Results: Among 104 patients, patients with GI symptoms included 66 cases (63.5%), those without GI symptoms accounted for 38 cases (36.5%). GI symptoms included: abdominal pain in 57 cases (54.8%), vomiting 21 cases (20.2%), GI bleeding 5 cases (4.8%), nausea 3 cases (2.9%) and diarrhea 3 case (2.9%). Positive GI symptoms and GI mucosal lesions on GI endoscopy had a statistically significant correlation with increased admission duration, treatment requirement, recurrence of HSP, and positive stool occult blood. Six cases with small intestinal wall thickening were noted on abdominal ultrasonography. Six cases of hemorrhagic gastritis and hemorrhagic duodenitis, 3 cases of duodenal ulcer, 3 cases of hemorrhagic gastritis and duodenal ulcer, 2 cases of hemorrhagic duodenitis and colitis, and 1 case of colitis were noted on GI endoscopy. Conclusion: These results suggest that GI endoscopic examination may be helpful for the diagnosis and treatment of children with HSP.

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Changing Patterns of Communicable Diseases in Korea (우리나라 전염성 질환의 변화 양상)

  • Lim, Hyun-Sul
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.2
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    • pp.117-124
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    • 2005
  • Before twentieth centuries and during early twentieth centuries, communicable diseases were the major cause of morbidity and mortality in Korea. But reliable data are not available. After 1975, the overall morbidity and mortality from communicable diseases, rapidly declined. Recently many new pathogenic microbes were recognized: L. monocytogenes, Hantaan virus, Y. pseudotuberculosis, P. multocida, L. pneumophilia, Human immunodeficiency virus (HIV), G. seoi, H. capsulatum, C. burnetii, V. cholerae O139, C. parvum, F. tularensis, E. coli O157:H7, B. burgdorferi, S. Typhimurium DT104, Rotavirus, hepatitis C virus and so on. Since the first HIV infection recognized in 1985, the reported cases of infection and deaths from HIV/AIDS have been steady increased each year. Legionnaire's disease, E. coli O157:H7 colitis, listeriosis and crytosporidiasis have been occurring just sporadically among immunocompromized cases. Many re-emerging communicable diseases were occurred in Korea: leptospirosis, malaria, endemic typhus, cholera, tsutsugamushi disease, salmonellosis, hepatitis A, shigellosis, mumps, measles, acute hemorrhagic conjunctivitis, brucellosis and so on. Leptospirosis and tsutsugamushi diseases have been noticed as major public health problems since 1980s. The malaria that had been virtually disappeared for a decade has reappeared from 1993 with striking increase of patients in recent 3-4 years. The distributions of salmonella and shigella serotypes have been changed a lot in recent few decades. Furthermore rapid emergence of antibiotic-resistant bacterial strains induces more difficult and complex problems in control of communicable diseases. We must recognize on the importance of environment and ecosystem conservation and careful prescription of anti-microbial agent in order to prevent communicable diseases.