CPHLN recommendations for the laboratory detection of Shiga toxin-producing Escherichia coli (O157 and non-O157).

Shiga toxin-producing Escherichia coli (STEC) are important enteric pathogens responsible for sporadic cases and outbreaks of gastroenteritis. E.coli O157:H7/NM (STEC O157) are the most commonly known STEC serotypes but it is now increasingly apparent that non-O157 STEC serotypes have been underreported in the past because they were not part of routine screening in many front-line laboratories. The Canadian Public Health Laboratory Network (CPHLN) has identified the need for improved detection and surveillance of non-O157 STEC and has developed the following recommendations to assist in the decision-making process for clinical and reference microbiology laboratories. These recommendations should be followed to the best of a laboratory's abilities based on the availability of technology and resources. The CPHLN recommends that when screening for the agents of bacterial gastroenteritis from a stool sample, front-line laboratories use either a chromogenic agar culture or a culture-independent diagnostic test (CIDT). CIDT options include nucleic acid amplification tests (NAATs) to detect Shiga toxin genes or enzyme immunoassays (EIAs) to detect Shiga toxins. If either CIDT method is positive for possible STEC, laboratories must have a mechanism to culture and isolate STEC in order to support both provincial and national surveillance as well as outbreak investigations and response. These CPHLN recommendations should result in improved detection of STEC in patients presenting with diarrhea, especially when due to the non-O157 serotypes. These measures should enhance the overall quality of healthcare and food safety, and provide better protection of the public via improved surveillance and outbreak detection and response.

NOD/LtSz-Rag1null mice: an immunodeficient and radioresistant model for engraftment of human hematolymphoid cells, HIV infection, and adoptive transfer of NOD mouse diabetogenic T cells.

Development of a small animal model for the in vivo study of human immunity and infectious disease remains an important goal, particularly for investigations of HIV vaccine development. NOD/Lt mice homozygous for the severe combined immunodeficiency (Prkdcscid) mutation readily support engraftment with high levels of human hematolymphoid cells. However, NOD/LtSz-scid mice are highly radiosensitive, have short life spans, and a small number develop functional lymphocytes with age. To overcome these limitations, we have backcrossed the null allele of the recombination-activating gene (Rag1) for 10 generations onto the NOD/LtSz strain background. Mice deficient in RAG1 activity are unable to initiate V(D)J recombination in Ig and TCR genes and lack functional T and B lymphocytes. NOD/LtSz-Rag1null mice have an increased mean life span compared with NOD/LtSz-scid mice due to a later onset of lymphoma development, are radioresistant, and lack serum Ig throughout life. NOD/LtSz-Rag1null mice were devoid of mature T or B cells. Cytotoxic assays demonstrated low NK cell activity. NOD/LtSz-Rag1null mice supported high levels of engraftment with human lymphoid cells and human hemopoietic stem cells. The engrafted human T cells were readily infected with HIV. Finally, NOD/LtSz-Rag1null recipients of adoptively transferred spleen cells from diabetic NOD/Lt+/+ mice rapidly developed diabetes. These data demonstrate the advantages of NOD/LtSz-Rag1null mice as a radiation and lymphoma-resistant model for long-term analyses of engrafted human hematolymphoid cells or diabetogenic NOD lymphoid cells.

Lymphadenopathy, elevated serum IgE levels, autoimmunity, and mast cell accumulation in flaky skin mutant mice.

The autosomal recessive mutation "flaky skin" (fsn) causes pleiotropic abnormalities in the immune and hematopoietic systems accompanied by pathologic changes in the skin. Homozygotes (fsn/fsn) showed increased size and histological alterations in the spleen and lymph nodes. Abnormalities in lymphoid architecture of the spleen in fsn/fsn mice were accompanied by marked increases in total numbers of B cells, macrophages, and immature erythroid cells. Splenic B cells displayed elevated MHC class II expression. Serum IgE levels were greater than 100 microg/ml by 10 weeks of age, representing > 7000-fold increase compared with normal littermates. This increased IgE level was associated with elevated IL-4 production by spleen cells and with increased amounts of serum IL-4. Serum IgM, IgG1, and IgG2b levels were also increased in fsn/fsn mice while IgG3 was decreased. Autoimmunity in fsn/fsn mice was evidenced by glomerulonephritis accompanied by immune complex deposition in the kidneys, increased serum blood urea nitrogen levels, and the presence of circulating anti-double-stranded DNA autoantibodies. Pathological changes in the skin of fsn/fsn mice were characterized by epidermal hyperplasia and mixed dermal inflammation. Increased numbers of mast cells were also observed in the dermis of the truncal skin as well as in the epithelial stomach. These marked immunological abnormalities suggest that the fsn locus encodes a major immunoregulatory molecule important in multiple immune and hematopoietic functions.

Ovine luteinizing hormone heterogeneity: androgens increase the percentage of less basic isohormones.

The heterogeneity of luteinizing (LH) is hormonally regulated with androgens having been reported to increase the percentage of extremely basic LH isohormones in the ovine pituitary. This study re-examined the effects of androgens on the heterogeneity of LH in the ovine pituitary because the extremely basic isoforms of LH reported previously were subsequently demonstrated to be artifacts resulting from the conditions used for chromatofocusing. Pituitary extracts from wethers, rams, and dihydrotestosterone (DHT)-implanted wethers were desalted by flow dialysis and chromatofocused on pH 10.5 to 7.0 gradients. LH was quantitated by radioimmunoassays. When compared with rams, wethers had increased percentages of LH isoforms eluting between pH 9.6 and 10. Patterns of intrapituitary LH isohormones were comparable in rams and DHT-implanted wethers except that rams had a higher percentage of LH eluting at pH 9.2 (20.9 +/- 2.1% vs. 13.3 +/- 1.3%). In contrast to what was previously reported, rams and DHT-implanted wethers had higher percentages of ovine LH isoforms eluting at pH's 9.4 or lower. Thus, androgens alter LH heterogeneity yielding increased percentages of isohormones eluting at pH's of 9.4 or lower.

Intergroup biases and eyewitness testimony.

The study examined how the in-group/out-group status of a perpetrator of a distinctly violent crime might influence an eyewitness's evaluation of his behavior and a witness's performance in an identification task. Immigrant and Swedish students saw a film showing a simulated robbery, with an immigrant or a Swede as the perpetrator. Results showed that both groups evaluated an ethnically dissimilar perpetrator as more culpable than an ethnically similar perpetrator. In a line-up task, both immigrant and Swedish participants mistakenly identified an innocent immigrant more often than an innocent Swede. Participants' biased evaluations of the perpetrator are discussed in terms of cognitive and motivational mechanisms. Expectations regarding the typical ethnicity of a perpetrator of this type of crime are suggested to account for the findings of the line-up task.

The fate of traumatic memories in childhood and adulthood.

The present article addresses issues concerning the complex relation between memory and trauma in childhood and adult life. Research findings showing how children and adults remember public and personal emotional events are presented, and mechanisms functioning to hold traumatic memories back from awareness are discussed. In the final section, developmental aspects are addressed by considering the interplay between child and adult trauma. Several cases are described that show how childhood trauma may be represented in memory and influence later development and adult memory processes.

Enhanced human CD4+ T cell engraftment in beta2-microglobulin-deficient NOD-scid mice.

Genetic crosses produced NOD/LtSz mice doubly homozygous for the severe combined immunodeficiency (scid) mutation and the beta2m (B2m) null allele. Both NOD/LtSz-scid/scid and NOD/LtSz-scid/scid B2m(null) mice lacked mature lymphocytes and serum Ig. However, homozygosity for the B2m(null) allele also resulted in the absence of MHC class I expression, loss of NK cell activity, accumulation of iron in the liver, and rapid clearance of human IgG1. NOD/LtSz-scid/scid B2m(null) mice supported markedly elevated levels of human T cell engraftment, compared with NOD/LtSz-scid/scid control animals, following injection with human PBMC. The increased engraftment was associated with a major increase in the number of human CD4+ T cells. Following injection with 20 million human PBMC, levels of human CD4+ T cells in the peripheral blood and spleen of NOD/ LtSz-scid/scid B2m(null) mice were 6- to 7-fold higher than those in NOD/LtSz-scid/scid mice and >50-fold higher than those in C.B-17-scid/scid mice. The resulting normalization of CD4+/CD8+ ratios in NOD/LtSz-scid/scid B2m(null) mice is in sharp contrast to that observed in NOD/LtSz-scid/scid mice or in C.B-17-scid/scid mice. Circulating human IgG was cleared 6-fold more rapidly in NOD/LtSz-scid/scid B2m(null) mice than in NOD/LtSz-scid/scid mice. This rapid IgG clearance suggested a failure of the engrafted human lymphoid cells to maintain high circulating levels of human IgG. The higher levels of human CD4+ T cells and the normalization of the CD4:CD8 ratio that are observed in human PBMC-engrafted NOD/LtSz-scid/scid B2m(null) mice suggest that this system may be an excellent model for studies of HIV pathogenesis.

Increased G-CSF responsiveness of bone marrow cells from hematopoietic cell phosphatase deficient viable motheaten mice.

The mouse mutation viable motheaten (me(v)) results in defects in the expression and catalytic activity of the cytoplasmic protein tyrosine phosphatase known as hematopoietic cell phosphatase (HCP). This reduction in HCP activity leads to the aberrant regulation of several myeloid and lymphoid cell lineages, including substantial increases in numbers of granulocytes. The differentiation, proliferation, and survival of cells in this lineage are normally supported by granulocyte-colony stimulating factor (G-CSF). In this study we have determined the consequences of the loss of HCP activity in me(v)/me(v) mice on the response of bone marrow cells to G-CSF. Bone marrow from these mice exhibited substantial increases in clonogenic and proliferative responses to G-CSF. These enhanced activities of G-CSF correlated with an increase in the level of immature granulocytic, G-CSF receptor positive cells in the bone marrow. These results suggested the possibility that HCP may regulate the G-CSF receptor by a direct interaction. However, under conditions where the previously described interaction between the erythropoietin receptor and HCP was readily observed, HCP did not detectably associate with the G-CSF receptor.

Carotid angiography in conjunction with amytal testing of epilepsy patients.

Angiography is carried out as a basic part of the sodium amobarbital procedure in most institutions in order to predict the distribution of the amobarbital before the procedure itself is performed. This paper presents details of cerebral circulation to provide a framework that will help investigators who are not radiologists to interpret angiography results. The application of angiography specifically to the amobarbital procedure and the implications of different patterns of arterial filling for interpretation of speech and memory test results are discussed.

Role of natural killer cells on engraftment of human lymphoid cells and on metastasis of human T-lymphoblastoid leukemia cells in C57BL/6J-scid mice and in C57BL/6J-scid bg mice.

The severe combined immunodeficiency (scid) mutation was backcrossed onto the C57BL/6J strain background in order to study the role of natural killer (NK) cells in rejection of normal and malignant human lymphohematopoietic cells. C57BL/6J-scid/scid mice showed severe loss of mature T and B cells accompanied by increased percentages of NK1.1+ cells and myeloid cells. Although little or no serum immunoglobulin was detectable prior to 2 months of age, all mice tested had circulating immunoglobulin by 7.5 months of age. C57BL/6J-scid/scid mice had markedly elevated levels of both hemolytic complement activity and NK cell activity compared with C57BL/6J - (+/+) controls. Weekly injections with anti-NK1.1 antibody resulted in elimination of NK cell activity in C57BL/6J-scid/scid mice throughout 8 weeks of treatment. Although human CEM-C7 T lymphoblastoid tumor cells grew slowly in unmanipulated C57BL/6J-scid/scid mice, anti-NK1.1 treatment resulted in increased growth accompanied by metastasis of human lymphoma cells to the brain, liver, and kidney. In contrast to T lymphoblastoid tumor cells, nonmalignant human peripheral blood mononuclear cells engrafted at low levels in anti-NK1.1-treated as well as in unmanipulated C57BL/6-scid/scid mice. Backcrossing of the beige (bgJ) mutation onto the C57BL/6-scid/scid genetic stock caused decreased NK cell activity accompanied by granulocyte defects. C57BL/6-scid/scid bgJ)/bgJ) mice showed metastasis of human CEM-C7 cells to the brain and other organs but supported only low levels of engraftment with human peripheral blood mononuclear cells. These results demonstrate that NK cells, in the absence of an adaptive immune system, function in resistance to metastasis of human lymphomas and suggest that innate immune factors in addition to NK cell function mediate resistance to engraftment of normal human peripheral blood leukocytes.

HIV-1 infectivity of human T cells in a human/murine chimeric fetal thymic organ culture system.

Human cord blood (HuCB) can colonize a murine fetal thymus organ culture (FTOC) and generate phenotypically immature (CD4+ CD8+) and mature (CD4+ CD8-; CD4- CD8+) T cells. We have used this model system to demonstrate that the human T cells that develop in this culture system can be infected with HIV-1. A cytopathic and non-cytopathic patient isolate of HIV-1 were used to infect FTOC established using C.B-17 or NOD/LtSz.scid/scid strain fetal thymic lobes colonized with HuCB. At 13-15 days after infection, FTOC were placed in co-culture with human PHA-blasts. These co-cultures demonstrated the presence of replicating HIV-1. Few human CD45+ cells were detectable in the thymic lobes that were infected with HIV-1, while high numbers of human CD45+ T cells were present in the uninfected cultures. These results demonstrate the cytopathicity of HIV-1 on human T lymphocytes that have developed in a HuCB colonized FTOC system.

Emv30null NOD-scid mice. An improved host for adoptive transfer of autoimmune diabetes and growth of human lymphohematopoietic cells.

When used as hosts in passive transfer experiments, a stock of NOD/Lt mice congenic for the severe combined immunodeficiency (scid) mutation have provided great insight to the contributions of various T-cell populations in the pathogenesis of autoimmune insulin-dependent diabetes mellitus (IDDM). Moreover, NOD-scid mice support higher levels of human lymphohematopoietic cell growth than the C.B-17-scid strain in which the mutation originated. However, the ability to perform long-term lymphohematopoietic repopulation studies in the NOD-scid stock has been limited by the fact that most of these mice develop lethal thymic lymphomas beginning at 20 weeks of age. These thymic lymphomas are characterized by activation and subsequent genomic reintegrations of Emv30, an endogenous murine ecotropic retrovirus unique to the NOD genome. To test the role of this endogenous retrovirus in thymomagenesis, we produced a stock of Emv30null NOD-scid mice by congenic replacement of the proximal end of chromosome 11 with genetic material derived from the closely related NOR/Lt strain. Thymic lymphomas still initiate in Emv30null NOD-scid females, but their rate of progression is significantly retarded since the frequency of tumors weighing between 170 and 910 mg at 25 weeks of age was reduced to 20.8% vs. 76.2% in Emv30% segregants. The thymic lymphomas that did develop in Emv30null NOD-scid mice were not characterized by a compensatory increase in mink cell focus-forming proviral integrations, which initiate thymomagenesis in other susceptible mouse strains. Significantly, the ability of standard NOD T-cells to transfer IDDM to the Emv30null NOD-scid stock was not impaired.(ABSTRACT TRUNCATED AT 250 WORDS)

Life satisfaction and sexuality in patients operated for epilepsy.

Changes in sexual behavior are often observed in patients with epilepsy. In order to investigate postoperative changes in sexuality and life satisfaction, operated and non-operated patients with epilepsy, as well as normal controls, were contacted for a survey. The questionnaire included 67 items concerning social background, life satisfaction, physical and psychological health, and sexuality (sexual desire, sexual contacts, sexual activity, etc). The results showed that patients with epilepsy do not rate overall life satisfaction much differently from neurologically normal control subjects. Specific questions regarding sexuality, revealed a lower sexual drive among the epilepsy patients compared with the controls. In most cases, there were no differences between the operated and the non-operated patients. Among the operated patients, the seizure-free group rated a higher level of life satisfaction and sexuality than the non-seizure free group.

Multiple defects in innate and adaptive immunologic function in NOD/LtSz-scid mice.

The scid mutation was backcrossed ten generations onto the NOD/Lt strain background, resulting in an immunodeficient stock (NOD/LtSz-scid/scid) with multiple defects in adaptive as well as nonadaptive immunologic function. NOD/LtSz-scid/scid mice lack functional lymphoid cells and show little or no serum Ig with age. Although NOD/(Lt-)+/+ mice develop T cell-mediated autoimmune, insulin-dependent diabetes mellitus, NOD/LtSz-scid/scid mice are both insulitis- and diabetes-free throughout life. However, because of a high incidence of thymic lymphomas, the mean lifespan of this congenic stock is only 8.5 mo under specific pathogen-free conditions. After i.v. injection of human CEM T-lymphoblastoid cells, splenic engraftment of these cells was fourfold greater in NOD/LtSz-scid/scid mice than in C.B17/Sz-scid/scid mice. Although C.B-17Sz-scid/scid mice exhibit robust NK cell activity, this activity is markedly reduced in both NOD/(Lt-)+/+ and NOD/LtSz-scid/scid mice. Presence of a functionally less mature macrophage population in NOD/LtSz-scid/scid vs C.B-17Sz-scid/scid mice is indicated by persistence in the former of the NOD/Lt strain-specific defect in LPS-stimulated IL-1 secretion by marrow-derived macrophages. Although C.B-17Sz-scid/scid and C57BL/6Sz-scid/scid mice have elevated serum hemolytic complement activity compared with their respective +/+ controls, both NOD/(LtSz-)+/+ and NOD/LtSz-scid/scid mice lack this activity. Age-dependent increases in serum Ig levels (> 1 micrograms/ml) were observed in only 2 of 30 NOD/LtSz-scid/scid mice vs 21 of 29 C.B-17/Sz-scid/scid animals. The multiple defects in innate and adaptive immunity unique to the NOD/LtSz-scid/scid mouse provide an excellent in vivo environment for reconstitution with human hematopoietic cells.

Amnesia and vegetative abnormalities after irradiation treatment: a case study.

This paper describes a case of a patient (GX) with a brain tumour in the third ventricle who developed a syndrome of amnestic disorder and vegetative abnormalities (hyperphagia, oligodipsia) after irradiation treatment that followed brain surgery. The patient shows an extremely poor long-term memory on both visually and verbally presented material, and of autobiographical events occurring after the onset of the illness, but some preserved memory functions on short-term memory tasks, semantic memory tasks, and implicit memory tasks. Given the onset of symptoms only after irradiation (a memory deficit in particular), and the non-invasive nature of the surgery, the probable etiology is post-irradiation syndrome.

Increased B lymphopoiesis in genetically sex steroid-deficient hypogonadal (hpg) mice.

Interleukin 7 (IL-7) responsive B lineage precursors were greatly expanded in genetically hypogonadal female (HPG/Bm-hpg/hpg) mice that have a secondary deficiency in gonadal steroidogenesis. Estrogen replacement in these mice resulted in a dose-dependent reduction in B cell precursors. More modest increases were documented in genetically normal mice that were surgically castrated. These findings complement other recent observations that B lymphopoiesis selectively declines in pregnant or estrogen-treated animals. Sex steroids have long been known to influence such disparate processes as bone physiology and tumor growth, in addition to their importance for reproductive function. We now show that these hormones are important negative regulators of B lymphopoiesis.

Comments on neuropsychological evaluation of epilepsy surgery: are the tests sensitive enough?

Epileptic lesions often affect two of the most important functions in human behavior, memory and emotion. While cognitive functions, e.g, speech and memory, are normally carefully studied, emotional and psychosocial aspects of behavior are often overlooked in the pre- and postoperative evaluation of epilepsy patients. In my comment, I will address the need for methodological and theoretical refinement, especially regarding measurements of emotional and psychosocial aspects. In evaluating memory functions, a functionalistic approach is suggested; that is, in contrast to the entity view, studies should focus on the interaction between task demands and the available cognitive capabilities of the rememberer. We should develop a broad set of tests and demonstrate dissociations between different tasks that tap different capabilities and different memory systems: we should look for patterns of results rather than single scores.

Hemisphere inactivation and mood-state changes.

Mood-state changes were studied during a sodium Amytal testing procedure in epilepsy patients with unilateral temporal lobe foci. The results showed that inactivation of the left hemisphere, but not the right hemisphere, produced a negative mood state. This decline in mood was not specifically related to side of focus or sex. As expected, the inactivation of either hemisphere also lead to an impairment in memory performance. This impairment was somewhat worse during a left than a right hemisphere inactivation. Furthermore, patients with left hemisphere foci showed a lower memory performance than patients with a right-hemisphere lesion. These results suggest (a) a hemispheric specialization for emotion that underlie changes in mood and (b) a discrepancy between mood states at encoding (during inactivation) and retrieval (after inactivation).