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Diabetic neuropathy is a common complication of diabetes that can cause pain, numbness and weakness in the extremities. In rare cases, it can also cause symptoms such as light-headedness or sexual dysfunction. While chronic high blood sugar is a known risk factor for diabetic neuropathy, little is known about why some patients with diabetes develop the condition and others do not, according to Jayashri Srinivasan, MD, PhD, a neurologist at Lahey. Srinivasan and her colleagues, Gyorgy Abel, MD, Laboratory Medicine; Mary Beth Hodge, MD, Endocrinology; and Stephanie Scala, CRA, Research, are researching links between diabetic neuropathy and inflammation. "One of the questions we are trying to answer is, `Is neuropathy just another complication of diabetes, or is it something else entirely?'" she says. Phase one of the team's study measured cytokines--chemicals released in the blood as part of an inflammatory response--in blood samples of three groups: patients who have diabetic neuropathy; patients with diabetes who do not have diabetic neuropathy; and healthy controls. While there are dozens of different cytokines present in the blood, the team measured 10 and found three in abnormal amounts in the blood of patients with diabetic neuropathy. "This was a simple experiment, " Srinivasan explains. "But our conclusion is that it is likely that these cytokines, and therefore inflammation, play an important role in the pathobiology of diabetic neuropathy." Specialized white blood cells called monocytes release cytokines in response to inflammatory stimuli. In the next.
7. Svenungsson E, Jensen-Urstad K, Heimburger M et al. Risk factors for cardiovascular disease in systemic lupus erythematosus. Circulation 2001; 104: 188793. Arnoux D, Boutiere B, Sanmarco M. [Antiphospholipid antibodies clinical significance and biological diagnosis]. Ann Biol Clin Pain 2000; 58: 55774. Love PE, Santoro SA. Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus SLE ; and in non-SLE disorders. Prevalence and clinical significance. Ann Intern Med 1990; 112: 68298. Wallace DJ. Does hydroxychloroquine sulfate prevent clot formation in systemic lupus erythematosus? Arthritis Rheum 1987; 30: 14356. Wallace DJ, Kinker-Isreli M, Metzger AL, Stecher VJ. The relevance of antimalarial therapy with regard to thrombosis, hypercholesterolemia and cytokines in SLE. Lupus 1993; 2: S13S15. 12. Fox RI, Kang HI. Mechanism of action of antimalarial drugs: inhibition of antigen processing and presentation. Lupus 1993; 2: S9S12. 13. Goldman FD, Gilman AL, Hollenback C, Kato RM, Premack BA, Rawlings DJ. Hydroxychloroquine inhibits calcium signals in T cells: a new mechanism to explain its immunomodulatory properties. Blood 2000; 95: 34606. Turpie AG. Antithrombotic effects of drugs which suppress platelet function: their potential in prevention growth of tumour cells. Prog Clin Biol Res 1982; 89: 3162. Hladovec J. Is the antithrombotic activity of `antiplatelet' drugs based on protection of endothelium? Thromb Haemost 1979; 41: 4748. Gallus AS, Hirsh J. Antithrombotic drugs: part II. Drugs 1976; 12: 13257. Billah M, Lapetina E, Cuatrecasas P. Phospholipase A2 activity and phospholipase C activities of platelets. Differential substrate specificity, Ca2 requirement, pH dependence, and cellular localization. J Biol Chem 1981; 256: 5399403. McCrea J, Robinson P, Gerrard J. Mepacrine quinacrine ; inhibition of thrombin-induced platelet responses can be overcome by lysophosphatidic acid. Biochim Biophys Acta 1985; 842: 18994. Jancinova V, Nosal R, Petrikova M. On the inhibitory effect of chloroquine on blood platelet aggregation. Thromb Res 1994; 74: 495504. Edwards MH, Pierangeli S, Liu X, Barker JH, Anderson G, Harris EN. Hydroxychloroquine reverses thrombogenic properties of antiphospholipid antibodies in mice. Circulation 1997; 96: 43804. Alarcon GS, Roseman J, Bartolucci AA et al. Systemic lupus erythematosus in three ethnic groups: II. Features predictive of disease activity early in its course. Arthritis Rheum 1998; 41: 117380. Reveille JD, Moulds JM, Ahn C et al. Systemic lupus erythematosus in three ethnic groups: I. The effects of HLA class II, C4, and CR1 alleles, socioeconomic factors, and ethnicity at disease onset. LUMINA Study Group. Lupus in minority populations, nature versus nurture. Arthritis Rheum 1998; 41: 116172. Alarcon GS, Friedman AW, Straaton KV et al. Systemic lupus erythematosus in three ethnic groups: III. A comparison of characteristics early in the natural history of the LUMINA cohort. LUpus in MInority populations: NAture vs. Nurture. Lupus 1999; 8: 197209. Tan EM, Cohen AS, Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982; 25: 12717. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997; 40: 1725. Liang MH, Fortin PR, Isenberg DA, Snaith L. Quantitative clinical assessment of disease activity in systemic lupus erythematosus: progress report and research agenda. Rheumatol Int 1991; 11: 1336. Liang MH, Socher SA, Larson MG, Schur PH. Reliability and validity of six systems for the clinical assessment of disease activity in systemic lupus erythematosus. Arthritis Rheum 1989; 32: 110718. Gladman DD, Urowitz MB, Goldsmith CH et al. The reliability of the Systemic Lupus International Collaborating Clinics American College.
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After adjusting for age, sex, country of residence, and medical history of allergy, autoimmune disorder, dyspepsia, and peptic ulcer, we found no significant association between use of histamine2-receptor antagonists, antibiotics for peptic ulcer, analgesics, or epilepsy medication and risk of any NHL subtypes examined table 4 ; . The estimates did not change appreciably after adjustment for the other potential confounders listed above data not shown
Adkins JC and Brogden RN 1998 ; Zafirlukast: A review of its pharmacology and therapeutic potential in the management of asthma. Drugs 55: 121144. Aizawa H, Inoue H, Matsumoto K, Nakano H and Hara H 1996 ; Thromboxane A2 antagonist inhibits leukotriene D4-induced smooth muscle contraction in guineapig lung parenchyma, but not in trachea. Prostaglandins Leukotrienes Essent Fatty Acids 55: 437 440. Arakida Y, Ohga K, Suwa K, Yokota M, Nagaoka H, Miyata K and Yamada T 1997 ; YM-57158, a newly synthesized dual antagonist for leukotriene LT ; D4 and thromboxane TX ; A2 receptors, in Abstracts of the XVI International Congress of Allergology Clinical Immunology, Suppl 4, p 69. Arakida Y, Suwa K, OhgA K, Yokota M, Miyata K, Yamada T and Honda K 1998 ; In vitro pharmacologic profile of YM158, a new dual antagonist for LTD4 and TXA2 receptors. J Pharmacol Exp Ther 287: 633 639. Ashida Y, Matsumoto T, Kuriki H, Shiraishi M, Kato K and Terao S 1989 ; A novel anti-asthmatic quinone derivative, AA-2414, with potent antagonistic activity against a variety of spasmogenic prostanoids. Prostaglandins 38: 91112. Barnes NC and Pujet JC on behalf of an International Study Group 1997 ; Pranlukast, a novel leukotriene receptor antagonist: Results of the first European, placebo controlled, multicentre clinical study in asthma. Thorax 52: 523527. Dahlen B, Zetterstrom O, Bjorck T and Dahlen SE 1994 ; The leukotriene-antagonist ICI-204, 219 inhibits the early airway reaction to cumulative bronchial challenge with allergen in atopic asthmatics. Eur Respir J 7: 324 331. Dahlen SE, Hedqvist P, Hammarstrom S and Samuelsson B 1980 ; Leukotrienes are potent constrictors of human bronchi. Nature Lond ; 288: 484 486. Francis HP, Greenham SJ, Patel UP, Thompson and Gardiner PJ 1991 ; Bay u3405 an antagonist of thromboxane A2- and prostaglandin D2-induced bronchoconstriction in the guinea-pig. Br J Pharmacol 104: 596 602. Fujimura M, Sakamoto S, Saito M, Miyake Y and Matsuda T 1991 ; Effect of thromboxane A2 receptor antagonist AA-2414 ; on bronchial hyperresponsiveness to methacholine in subjects with asthma. J Allergy Clin Immunol 87: 2327. Howell RE, Sickels BD, Woeppel SL, Jenkins LP, Rubin EB and Weichman BM 1994 ; Leukotrienes mediate antigen-induced airway hyper-reactivity in guinea pigs. J Pharmacol Exp Ther 268: 353358. Jones GL, Saroea HG, Watson RM and O'Byrne 1992 ; Effect of an inhaled thromboxane mimetic U46619 ; on airway function in human subjects. Rev Respir Dis 145: 1270 1274. Kawikova I, Arakawa H, Skoogh BE, Lofdahl CG and Lotvall J 1996 ; U46619 a.
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13 14. Banerji S, Ni J, Wang SX, Clasper S, Su J, Tammi R, Jones M, Jackson DG. LYVE-1, a new homologue of the CD44 glycoprotein, is a lymph-specific receptor for hyaluronan. J Cell Biol 1999; 144: 789-801. Hardwick KG, Hoare K, Owens R, Hohn HP, Hook M, Moore D, Cripps V, Austen L, Nance DM, Turley EA. Molecular cloning of a novel hyaluronan receptor that mediates tumor cell motility. J Cell Biol 1992; 117: 1343-1350. Turley EA, Hossain MZ, Sorokan TJLM, Nagy JI. Astrocyte and microglial motility in vitro is functionally dependent on the hyaluronan receptor RHAMM. Glia 1994; 12: 68-80. Ahrens T, Assmann V, Fieber C, Termeer C, Herrlich P, Hofmann M, Simon JC. CD44 is the principal mediator of hyaluronic-acid-induced melanoma cell proliferation. J Invest Dermatol 2001; 116: 93-101. Campbell S, Swann HR, Aplin JD, Seif MW, Kimber SJ, Elstein M. CD44 is expressed throughout pre-implantation human embryo development. Hum Reprod 1995; 10: 425-430. Kano K, Miyano T, Kato S. Effects of glycosaminoglycans on the development of in vitro-matured and -fertilized porcine oocytes to the blastocyst stage in vitro. Biol Reprod 1998; 58: 1226-1232. Kimura N, Konno Y, Miyoshi K, Matsumoto H, Sato E. Expression of hyaluronan synthases and CD44 messenger RNAs in porcine cumulus-oocyte complexes during in vitro maturation. Biol Reprod 2002; 66: 707-717. Valcarcel A, de Matos DG, Furnus CC. The hyaluronic acid receptor CD44 ; expressed in bovine oocytes and preimplantational stage embryos. Theriogenology 1999; 51, 193 abstract ; . 22. Prevo R, Banerji S, Ferguson DJ, Clasper S, Jackson DG. Mouse LYVE-1 is an endocytic receptor for hyaluronan in lymphatic endothelium. J Biol Chem 2001; 276: 19420-19430. Assmann V, Marshall JF, Fieber C, Hofmann M, Hart IR. The human hyaluronan receptor RHAMM is expressed as an intracellular protein in breast cancer cells. J Cell Sci 1998; 111: 1685-1694. Assmann V, Jenkinson D, Marshall JF, Hart IR. The intracellular hyaluronan receptor RHAMM IHABP interacts with microtubules and actin filaments. J Cell Sci 1999; 112: 3943-3954 and kava
SIR: Manganese intoxication is a well-known cause of parkinsonism and dementia.1 It affects welders, miners, steelworkers, and workers in other occupations. The presenting signs of chronic manganism include disorientation, impairment of memory and judgment, acute anxiety, emotional lability, compulsive acts, hallucinations, illusions, and delusions. Extrapyramidal syndromes resembling Parkinson's disease include characteristic neurologic manifestations.1, 2 The underlying mechanisms whereby manganese develops toxicity are unknown. The diagnostic hallmarks are occupational exposure, a compatible clinical syndrome, and high levels of manganese in blood or urine. T1-weighted MRI has been reported to be useful in the diagnosis of manganese intoxication because of high signal intensity areas in the basal ganglia.3 Case Report We describe a 14-year follow-up of a chronic enteral manganese poisoning. A 66-year-old male patient with proven manganese poisoning was treated in our hospital. The complete case was published in 1986.4 Fourteen years after the intoxication, the now 80-year-old patient is still alive. We examined the patient in our hospital again. Clinical, neurological, and psychiatric examinations were performed in the same manner described before.4 The patient was alert, oriented, and coherent but slow in mentation. His speech was slightly dysarthric, and a shortening of the patient's gait was noticed. The gastrocnemius tendon reflex was reduced bilaterally, hemihypesthesia was reported in both hands, and there.
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Riehle A, Grun S, Diesmann M, Aertsen A. Spike synchronization and rate modulation differentially involved in motor cortical function. Science 1997; 278: 19503. Sanes JN, Donoghue JP. Oscillations in local eld potentials of the primate motor cortex during voluntary movement. Proc Natl Acad Sci USA 1993; 90: 44704. Schluter ND, Rushworth MF, Mills KR, Passingham RE. Signal-, set-, and movement-related activity in the human premotor cortex. Neuropsychologia 1999; 37: 23343. Schubert T, Volkmann J, Muller U, Sturm V, Voges J, Freund HJ, et al. Effects of pallidal deep brain stimulation and levodopa treatment on reaction-time performance in Parkinson's disease. Exp Brain Res 2002; 144: 816. Schultz W, Romo R. Role of primate basal ganglia and frontal cortex in the internal generation of movements. I. Preparatory activity in the anterior striatum. Exp Brain Res 1992; 91: 36384. Shibata T, Shimoyama I, Ito T, Abla D, Iwasa H, Koseki K, et al. Eventrelated dynamics of the gamma-band oscillation in the human brain: information processing during a GO NOGO hand movement task. Neurosci Res 1999; 33: 21522. Silberstein P, Kuhn AA, Kupsch A, Trottenberg T, Krauss J, Wohrle JC, et al. Patterning of globus pallidus local eld potentials differs between Parkinson's disease and dystonia. Brain 2003; 126: 2597608. Sochurkova D, Rektor I. Event-related desynchronization synchronization in the putamen. An SEEG case study. Exp Brain Res 2003; 149: 4014. Starr PA, Vitek JL, Bakay RA. Ablative surgery and deep brain stimulation for Parkinson's disease. Neurosurgery 1998; 43: 9891013. Tachibana H, Aragane K, Miyata Y, Sugita M. Electrophysiological analysis of cognitive slowing in Parkinson's disease. J Neurol Sci 1997; 149: 47 Taylor WA. Change-point analysis: a powerful new tool for detecting changes. 2000. Available from : variation cpa tech changepoint Thut G, Hauert C, Viviani P, Morand S, Spinelli L, Blanke O, et al. Internally driven vs. externally cued movement selection: a study on the timing of brain activity. Brain Res Cogn Brain Res 2000; 9: 2619. Tobimatsu S, Shima F, Ishido K, Kato M. Visual evoked potentials in the vicinity of the optic tract during stereotactic pallidotomy. Electroencephalogr Clin Neurophysiol 1997; 104: 2749. Tsubokawa T, Sutin J. Pallidal and tegmental inhibition of oscillatory slow waves and unit activity in the subthalamic nucleus. Brain Res 1972; 41: 1018. Wennberg RA, Lozano AM. Intracranial volume conduction of cortical spikes and sleep potentials recorded with deep brain stimulating electrodes. Clin Neurophysiol 2003; 114: 140318. Werheid K, Zysset S, Muller A, Reuter M, von Cramon DY. Rule learning in a serial reaction time task: an fMRI study on patients with early Parkinson's disease. Brain Res Cogn Brain Res 2003; 16: 27384. Wichmann T, Bergman H, DeLong MR. The primate subthalamic nucleus. I. Functional properties in intact animals. J Neurophysiol 1994; 72: 494 Williams D, Tijssen M, Van Bruggen G, Bosch A, Insola A, Di Lazzaro V, et al. Dopamine-dependent changes in the functional connectivity between basal ganglia and cerebral cortex in humans. Brain 2002; 125: 155869. Williams D, Kuhn AA, Kupsch A, Tijssen M, Van Bruggen G, Speelman H, et al. Behavioural cues are associated with modulations of synchronous oscillations in the human subthalamic nucleus. Brain 2003; 126: 197585 and kenalog.
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54. Kawano M, Hirano T, Matsuda T, et al. Autocrine generation and requirement of BSF-2 IL-6 for human multiple myelomas. Nature 1988; 332: 83-85. Klein B, Zhang XG, Jourdan M, et al. Paracrine rather than autocrine regulation of myeloma-cell growth and differentiation by interleukin-6. Blood 1989; 73: 517-526. Brandt SJ, Bodine DM, Dunbar CE, et al. Dysregulated interleukin-6 expression produces a syndrome resembling Castleman's disease in mice. J Clin Invest 1990; 86: 592-599. Ravoet C, De Grve J, Vandewoude K, et al. Tumor stimulating effects of recombinant interleukin-6. Lancet 1994; 344: 1576-1577. Nieken J, Mulder NH, Buter J, et al. Recombinant human interleukin-6 induces a rapid and reversible anemia in cancer patients. Blood 1995 in press ; . 59. Atkins MB, Kappler K, Mier JH, et al. Interleukin-6 associated anemia: determination of the underlying mechanism. Proc Soc Clin Oncol 1994; 13: 295 abstract ; . 60. Ault KA, Mitchell J, Knowles C, et al. Recombinant human interleukin eleven NeumegaTM rhIL-11 growth factor ; increases plasma volume and decreases sodium excretion in normal human subjects. Blood 1994; 84 suppl 1 ; : 267a abstract ; . 61. Kobune M, Kohgo Y, Kato J, et al. Interleukin-6 enhances hepatic transferrin uptake and ferritin expression in rats. Hepatology 1994; 19: 1468-1475.
Fig 9. Boundaries of the 21PBA target sequence. 21PBA binds the 3 -half of the 44-bp promoter fragment. HL-60 cell extract was incubated with either the 44-bp fragment or 23- or 29-bp fragments bearing identical sequence to the 3 portion of the longer fragment. All targets generate the same gel-shift band, which can be specifically competed, as shown. The 44-bp fragment is significantly more effective than the shorter fragments as a cold competitor against labeled 44- or 28-bp fragments. The bottom portion of the figure depicts the positions of recognition sites for several transcription factors relative to fragment boundaries and keppra.
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1. Cammarota G, Cianci R, Cannizzaro O et al. Efficacy of two oneweek rabeprazole levofloxacin-based triple therapies for Helicobacter pylori infection. Aliment Pharmacol Ther 2000; 14: 133943. Cheon JH, Kim N, Lee DH et al. Trial of moxifloxacin-containing triple therapy after initial and second-line treatment failures for Helicobacter pylori infection. Kor J Gastroenterol 2005; 45: 1117. Kim JM, Kim JS, Jung HC et al. Distribution of antibiotic MICs for Helicobacter pylori strains over a 16-year period in patients from Seoul, South Korea. Antimicrob Agents Chemother 2004; 48: 48437. National Committee for Clinical Laboratory Standards. Performance Standards for Antimicrobial Susceptibility Testing--Twelfth Informational Supplement M100-S12. NCCLS, Wayne, PA, USA, 2002. 5. Tankovic J, Lascols C, Sculo Q et al. Single and double mutations in gyrA but not in gyrB are associated with low- and high-level fluoroquinolone resistance in Helicobacter pylori. Antimicrob Agents Chemother 2003; 47: 39424. Moore RA, Beckthold B, Wong S et al. Nucleotide sequence of the gyrA gene and characterization of ciprofloxacin-resistant mutants of Helicobacter pylori. Antimicrob Agents Chemother 1995; 39: 10711. Fujimura S, Kato S, Iinuma K et al. In vitro activity of fluoroquinolone and the gyrA gene mutation in Helicobacter pylori strains isolated from children. J Med Microbiol 2004; 53: 101922. Debets-Ossenkop YJ, Herscheid AJ, Pot RG et al. Prevalence of Helicobacter pylori resistance to metronidazole, clarithromycin, amoxicillin, tetracycline and trovafloxacin in The Netherlands. J Antimicrob Chemother 1999; 47: 5115. Cabrita J, Oleastro M, Matos R et al. Features and trends in Helicobacter pylori antibiotic resistance in Lisbon area, Portugal 19901999 ; . J Antimicrob Chemother 2000; 46: 102931. Heep M, Kist M, Strobel S, et al. Secondary resistance among 554 isolates of Helicobacter pylori after failure of therapy. Eur J Clin Microbiol Infect Dis 2000; 19: 53841.
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1. Barlett JG. Management of Clostridium difficile infection and other antibiotic associated diarrhoea. Eur J Gastroenterol Hepatol 1996; 8: 1054-1061. Katz DA, Lynch ME, Littenberg B. Clinical prediction rules to optimize cytotoxin testing for Clostridium difficile in hospitalized patients with diarrhoea. J Med 1996; 100: 487-495. Fekety R. Guidelines for the diagnosis and management of Clostridium difficile - associated diarrhoea and colitis. J Gastroenterol 1997; 92: 739-750. Barlett JG. Antibiotic-associated diarrhoea. N Engl J Med 2002; 346: 334-339. Hogenauer C, hammer HF. Krejs GJ, Reisinger EC. Mechanism and management of antibioticassociated diarrhoea. Clin Infect Dis 1998; 27: 702710. Barlett JG. Antibiotic associated diarrhoea. Clin Infect Dis 1992; 15: 573-581. Larson HE, Price AB, Honour P, Borriello SP. Clostridium difficile and the etiology of pseudomembranous colitis. Lancet 1978; 1: 10631066. Bignardi GE, Risk factors for clostridial infection. J Hosp Infect 1998; 40: 1-15. Hecht JR, Olinger EJ. Clostridium difficile colitis secondary to intravenous vancomycin. Dig Dis Sci 1989; 34: 148-149. Anand A, Glatt AE. Clostridium difficile infection associated with antineoplastic chemotherapy: A review. Clin Infect Dis 1993; 17: 109-113. Wilcox MH, Smyth ETM. Incidence and impact of Clostridium difficile infection in the UK, 1993-1996. J Hosp Infect 1998; 39: 181-187. McFarland LV, Mulligan ME, Kwok RYY, Stamm WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989; 320: 204-210. Fekety R, Kim KH, Brown D, Batts DH, Cudmore M, Silva J Jr. Epidemiology of antibiotic associated colitis: Isolation of Clostridium difficile from the hospital environment. J Med 1981; 70: 906-908. von Eichel-Streiber C, Laufenberg-Feldmann R, Sartingen S, Schulze J, Sauerborn M. Cloning of Clostridium difficile toxin B gene and demonstration of N-terminal homology between toxin A and B. Med Microbiol Immunol 1990; 179: 271-279. Pathoulakis C. Pathogenesis of Clostridium difficileassociated diarrhoea. Eur J Gastroenterol Hepatol 1996; 8: 1041-1047. Pathoulakis C, Barone LM, Ely R, Faris B, Clark ME, Franzblau C, KaMont JT. Purification and properties of Clostridium difficile cytotoxin B. J Biol Chem 1986; 26: 1316-1321. Kato H, Kato N, Watanable K, Iwai N, Nakamura H, Yamamoto T, Suzuki K, Kim SM, Chong Y, Wasito EB. Identification of Toxin A-negative, toxin B-positive Clostridium difficile by PCR. J Clin Microbiol 1998; 36: 2178-2182. Riegler M, Sedivy R, Pathoulakis C, Hamilton G, Zacherl J, Bischof G, Cosentini E, Feil W, Schiessel R, La Mount JT. Clostridium difficile toxin B is more potent than toxin A in damaging human colonic epithelium in vitro. J Clin Invest 1995; 95: 2004-2011. Chakrabarti A, Ayyagari A, Chakrabarti RN. Animal Models of Antibiotic Associated Colitis. In: Proceedings of the First Asian Congress on Anaerobic Bacteria in Health and Disease. Eds Mehta A, Kochar N Seth GS Medical College & K.E.M. Hospital, Bombay, India ; 1987: 260-266. 20. Kelly CP. Immune response to Clostridium difficile infection. Euro J Gastroenterol Hepatol 1996; 8: 1048-1053. Kelly CP, Pothoulakis, C, LaMont JT. Clostridium difficile colitis. N Engl J Med 1994; 330: 257-262. Eglow R, Pothoulakis C, Itzkowitz S, Israel EJ, O'Keane CJ, Gong D, Gao N, XuYL, Walker WA, La Mount JT. Diminished Clostridium difficile toxin A sensitivity in newborn rabbit ileum is associated with decreased toxin A receptor. J Clin Invest 1992; 90: 822-829. Peterson LR, Kelly PJ, Nordbrock HA. Role of culture and toxin detection in laboratory testing for diagnosis of Clostridium difficile-associated diarrhoea. Eur J Clin Microbiol Infect Dis 1996; 15: 330-336. Brazier JS. The diagnosis of Clostridium difficileassociated disease. J Antimicrob Chemother 1998; 41: 29-40.
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