In addition to the two major toxins of Clostridium difficile--toxins A and B, which represent the major virulence factors--a number of other putative virulence factors have been described. These factors include fimbriae and the ability to associate with gut cells/mucus, the production of a capsule, the secretion of a range of hydrolytic enzymes, the production of other toxins (such as an actin-specific ADP-ribosyltransferase by some strains), and the controversial possibility of the production of a second enterotoxin. The extent to which these additional putative virulence factors are involved in the pathogenesis of C. difficile-related gut disease remains to be elucidated.

Bacterial Adhesion↗

PubMedDate not supplied

Liver metastasis nineteen years after surgery for typical bronchial carcinoid.

A resected case of metastatic liver carcinoid is presented. A 62 year-old woman, who had undergone removal of a typical bronchial carcinoid 19 years before, was found to have a well-defined, oval hepatic tumor on ultrasonography. The resected specimen was a hard and solid tumor, which was microscopically diagnosed as a carcinoid. Histological review of the previously resected lung tumor revealed that the liver tumor was a metastasis from the primary bronchial carcinoid. The patient is alive without recurrence 42 months after hepatectomy. This case suggests that typical bronchial carcinoid, a slowly growing tumor, may metastasize to distant sites after many years, and that re-excision of metastatic lesions may prolong survival time.

Carcinoid Tumor↗

PubMedDate not supplied

Hepatic blood flow after acute biliary obstruction and drainage in conscious dogs.

BACKGROUND AIMS: Obstructive jaundice is a factor which effects hepatic blood flow and the relative contribution of the hepatic arterial flow and portal venous flow. In this study, and were measured in conscious dogs and the influence of biliary obstruction and drainage was investigated. MATERIAL AND METHODS: Hepatic arterial flow (HAF) and portal venous flow (PVF) after biliary obstruction and subsequent drainage were continuously measured in conscious dogs using implantable transit time ultrasonic flow-meters. RESULTS: After biliary obstruction hepatic arterial flow rapidly increased compared to the pre-obstructed values(p < 0.01), while portal venous flow was significantly decreased (p < 0.01). Total hepatic blood flow was initially increased (p < 0.01) until 2 hours after obstruction. It then decreased gradually. After 2 weeks, it was less than the pre-obstructed values, but this was not significant. Biliary drainage was performed after 2 weeks. Hepatic arterial flow subsequently decreased (p < 0.01) and portal venous flow increased (p < 0.05). Blood flow did not change. CONCLUSION: Biliary obstruction resulted in significant changes in liver circulation. Biliary drainage facilitated recovery from these changes.

Animals↗