Evaluation of a monoclonal antibody-based enzyme-linked immunosorbent assay for detection of Campylobacter fetus in bovine preputial washing and vaginal mucus samples.

A monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA) was described and evaluated for use as a presumptive screening test for detection of Campylobacter fetus in bovine preputial washing and vaginal mucus samples. A total of 725 diagnostic samples collected in the field and submitted in Clark's transport enrichment medium (TEM) were analyzed. Cultural isolation of C. fetus was used as the standard for comparison. After incubation of the TEM vials for 4-5 days, fluid was removed for culture and ELISA testing. A sandwich ELISA format was used and the target antigen was C. fetus lipopolysaccharides (LPS). A rabbit anti-C. fetus polyclonal antiserum was used as the capture antibody. Murine monoclonal antibodies (MAbs) to C. fetus serotype A and B LPS core and O-polysaccharides and a goat anti-mouse horseradish peroxidase conjugate were used as detection antibodies. ELISA and culture results for the diagnostic samples were in complete agreement. Seven hundred and eight samples were negative by both tests. All 17 culture positive samples were positive by ELISA with a MAb to LPS core. The ELISA with MAbs to LPS O-polysaccharides detected all culture positive samples with the homologous C. fetus serotype. Sixty-six preputial wash samples from three known C. fetus culture positive bulls were also analyzed. Forty-nine of these samples were positive by both ELISA and culture, 16 were positive by ELISA only, and one was negative by both ELISA and culture. The results indicate that this ELISA is useful as a screening test for the detection of C. fetus in diagnostic samples.

Identification and serological specificity of a polysaccharide component from Mycoplasma bovis.

Whole-cell lysate and proteinase K digest preparations of the Mycoplasma bovis type strain (American Type Culture Collection 25523) were compared using sodium dodecyl sulfate polyacrylamide gel electrophoresis. Coomassie blue staining for protein revealed approximately 50 bands for the lysate but only a single band for the digest. Silver staining for polysaccharide revealed at least 19 bands for the digest. Fourteen monoclonal antibodies (MAbs) were produced using a screening procedure with an M. bovis digest. On immunoblots of digests of four M. bovis strains, an almost identical profile was seen with each strain for all 14 MAbs but differences were evident between strains. One MAb, M1557, was used to analyse 17 M. bovis strains on immunoblots. Ten to 20 bands were observed with 16 of the 17 strains, and differences were apparent among all 16 strains. In an enzyme-linked immunosorbent assay, M1557 reacted with 16 of the 17 M. bovis strains, but did not react with any of 41 non-M. bovis organisms tested. Strong reactions were observed with the MAbs and M. bovis colonies in immunofluorescence. The M. boris polysaccharide and MAbs to this component may be useful for the development of diagnostic assays for this organism.

Monoclonal antibodies specific for Campylobacter fetus lipopolysaccharides.

Four monoclonal antibodies (mAbs) (M1357, M1360, M1823 and M1825) which reacted with Campylobacter fetus lipopolysaccharide (LPS) core region epitopes were produced and characterized. Reactivity of these mAbs with C. fetus core LPS epitopes was determined by enzyme-linked immunosorbent assay (ELISA) with whole cell proteinase K digests and phenol-water extracted LPS, and by immunoblotting with proteinase K digests. The specificities of the four mAbs were evaluated using an indirect ELISA. One of the mAbs reacted with 42 and three of the mAbs reacted with 41 of the 42 C. fetus strains examined. No reaction was observed between the four mAbs and 32 non-C. fetus bacteria tested, with the exception of one mAb with one organism. The four mAbs reacted with serotype A and B strains indicating the presence of shared epitopes in C. fetus LPS core oligosaccharides. The specificities of three mAbs previously produced to C. fetus LPS O-antigens (M1177, M1183 and M1194) were also evaluated and no reaction was observed with these mAbs and the 32 non-C. fetus bacteria tested. Strong immunofluorescence reactions were observed with the anti-O chain mAbs and selected C. fetus strains of the homologous serotype. These anti-LPS core oligosaccharide and anti-LPS O chain mAbs are highly specific for C. fetus and are potentially useful as immunodiagnostic reagents for detection, identification and characterization of C. fetus.

Identification, characterization, and variation in expression of two serologically distinct O-antigen epitopes in lipopolysaccharides of Campylobacter fetus serotype A strains.

Monoclonal antibodies (MAbs) to the lipopolysaccharide (LPS) O-antigens of Campylobacter fetus serotype A and B strains were produced. Eight MAbs specific for serotype A LPS were characterized on immunoblots of C. fetus serotype A LPS. Two immunoblot patterns were observed and were used to divide the eight MAbs into two groups. MAbs M1177 and M1194 were selected as representative of the two groups and were used in an enzyme-linked immunosorbent assay (ELISA) to examine the LPS O-antigen epitopes of 37 serotype A C. fetus subsp. fetus and C. fetus subsp. venerealis strains. Thirty-three strains (89%) reacted with both M1177 and M1194, 2 strains reacted only with M1177, and 2 strains reacted only with M1194. To further characterize the O-antigen epitopes, purified serotype A LPS was treated using various temperature and pH conditions and the effect of the treatments on the reactivity of the LPS with MAbs M1177 and M1194 was evaluated by ELISA. While no difference among several treatments was observed, heating serotype A LPS under alkaline conditions decreased the reaction with M1177 to background levels and increased the reaction with M1194. MAbs M1177 and M1194 were also used with ELISA to investigate in vivo and in vitro expression of the two O-antigen epitopes. There was substantial variation in expression of the two epitopes among weekly isolates of two C. fetus serotype A strains recovered from experimentally infected heifers. There was minimal variation in expression of the two epitopes in successive subcultures of three C. fetus serotype A strains.

Staffing intensity, skill mix and mortality outcomes: the case of chronic obstructive lung disease.

The hospital re-engineering movement has resulted in major changes in hospital staffing. These staffing changes have the potential to reduce staffing intensity and skill mix, both generally and within specific caregiver groups. Prior research has shown that both skill mix and staffing intensity are positively associated with outcomes indicative of the quality of hospital care. This study extends beyond prior research by expanding the scope of staffing intensity and skill mix measures beyond that of physicians and nursing personnel and by focusing on a specific diagnostic group, patients with chronic obstructive pulmonary disease (COPD). Multiple regression analysis was performed using the 30-day post-admission observed mortality rate for Medicare patients being treated for COPD relative to the predicted rate as the dependent variable. Analyses were repeated for 1989, 1990 and 1991. Among the explanatory variables were staffing intensity measures for health care workers that were thought to contribute significantly to the care needed by patients with COPD. The results indicate that the only group of health care workers which showed staffing intensities positively associated with better outcomes in this group of patients was respiratory care practitioners, respiratory therapists and respiratory therapy technicians. The results relative to skill mix were inconclusive. It was concluded that during the 1989-1991 period, hospitals with higher staffing intensities for both respiratory therapists and respiratory therapy technicians had better outcomes for their Medicare inpatients being treated for COPD.

Skill-specific staffing intensity and the cost of hospital care.

Hospital managers have changed their staffing strategies to reduce the cost of care. Such hospitals may be both understaffed and underskilled in terms of some caregivers. Understaffing and underskilling may have indirect effects that offset the benefits of payroll cost reductions. This article indicates that in 1991 some California hospitals were understaffed in terms of specific bedside caregivers and had higher costs than did hospitals employing more of those caregivers.

Characterization of monoclonal antibodies for the rapid detection of foodborne campylobacters.

The specificity of 97 monoclonal antibodies (MAbs) to the Campylobacter jejuni Lior serogroup 6 reference strain was assessed using an indirect enzyme linked immunosorbent assay (ELISA). Four MAbs, M316, M337, M357 and M637, reacted with whole cells of the C. jejuni, C. coli and C. lari reference strains of the 20 most common Lior serogroups and 25 recent C. jejuni and C. coli isolates, and did not react with most of the 42 other Campylobacter and non-Campylobacter spp. tested. Immunoblot analysis revealed that MAbs M337 and M357 reacted with a protein component with molecular mass of approximately 62 kiloDaltons (kDa) while M316 and M637 reacted with protein components of approximately 92 and 31 kDa, respectively. The detection limit of M357 in an indirect ELISA was 10(5) colony forming units. These four highly specific MAbs may be useful reagents of an immunoassay for the rapid detection of thermophilic campylobacters in foods and clinical samples.

Electrophoretic and immunoblot analysis of Campylobacter fetus lipopolysaccharides.

Proteinase K-digested cell lysates from 25 Campylobacter fetus subspecies fetus and C. fetus subsp. venerealis strains were examined by SDS-PAGE and immunoblotting. Three SDS-PAGE lipopolysaccharide (LPS) profiles were observed. Two profiles were consistent with those previously reported for serogroup A and serogroup B and AB isolates and were distinguished by the relative mobility of bands in the O-chain region and by a strong reaction on immunoblots with homologous antisera. The third profile was similar but had faster migrating O-chain bands. Immunoblot reactions using homologous and heterologous adsorbed antisera showed that the O-antigen of the C. fetus subsp. fetus reference strain and other profile 2-type LPS strains was distinct from the O-antigens of strains with profile 1- or profile 3-type LPS. O-antigens of strains with profile 1- and profile 3-type LPS had shared epitopes. One strain had core components but no detectable O-antigens. Common core LPS antigens appear to be present in all strains and antibodies to common core LPS epitopes may be useful reagents for rapid detection of C. fetus.

Mycobacterium paratuberculosis antigen D: characterization and evidence that it is a bacterioferritin.

By using a combination of agarose and polyacrylamide gel electrophoresis, Mycobacterium paratuberculosis antigen D was resolved from a crude sonicated preparation of the organism and characterized as a component with a molecular mass of approximately 400,000 Da. While this component was composed mainly of protein, with unusually high proportions of glutamic acid and leucine, it was resistant to digestion with a number of proteolytic enzymes. Structural detail revealed by electron microscopy, amino acid sequence data, and the demonstration of a Soret band in its absorption spectrum indicated that antigen D was similar to an Escherichia coli bacterioferritin.

Multiple pulmonary microemboli complicating pneumonectomy.

Pulmonary embolism is widely recognized to complicate abdominal and lower limb orthopedic surgical procedures, but in comparison, it is seldom recognized to hamper the postoperative progress of patients after thoracic operations. We present 4 patients in whom multiple pulmonary emboli developed after pneumonectomy, 2 of whom were treated successfully. We discuss the mostly atypical presentation and the physiological and clinical consequences, and also suggest a mode of management.

Central nervous system lesions in pediatric patients: Gd-DTPA-enhanced MR imaging.

Twenty pediatric patients, aged 2-18 years, with known or suspected masses in the brain and/or spinal cord were studied with magnetic resonance imaging at 0.6T with and without use of 0.1 mmol/kg gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA). The multisection, multiecho imaging mode was utilized. Surgically proved mass lesions included astrocytoma (n = 6), medulloblastoma (n = 2), ependymoma (n = 1), craniopharyngioma (n = 1), oligodendroglioma (n = 1), germinoma (n = 1) and fibrosarcoma (n = 1). Presumptive diagnoses included astrocytoma (n = 3), arachnoid cyst (n = 1), tuberous sclerosis (n = 1), cryptic vascular malformation (n = 1), and normal (n = 1). There was dramatic enhancement in 11 of 20 patients, with improved definition of the presence and extent of lesions in six patients. No adverse effects were noted in any of the 20 patients. It is concluded that Gd-DTPA is useful in delineating the presence, extent, and number of certain lesions of the central nervous system in children.

Evaluation of the serological response of sheep in one flock to Mycobacterium paratuberculosis by crossed immunoelectrophoresis.

Sera from 74 sheep culled from one flock on the basis of performance and response to immunological tests for paratuberculosis or maedi visna were used to evaluate the serological response to a sonicated antigen of Mycobacterium paratuberculosis by crossed immunoelectrophoresis. A total of seven precipitating components was demonstrated. Four components (A,C,V,W) were detected in low frequency only with sera from animals with paratuberculosis while two components (X,Y) were detected in high frequency with sera from animals with or without paratuberculosis. One component (D) was observed in high frequency with sera from animals with paratuberculosis. The magnitude of the serological response to the D component as measured by crossed immunoelectrophoresis correlated well with bacterial load and generally agreed with the quantitative assessment by agar gel immunodiffusion. A development time for crossed immunoelectrophoresis of 24-72 hours after electrophoresis was required to achieve correlation with agar gel immunodiffusion.

Toxic megacolon due to ischemic enterocolitis associated with retroperitoneal fibrosis.

A 46-yr-old man, in whom retroperitoneal fibrosis had been found 4 yr previously, presented with abdominal pain, fever, diarrhea, and marked dilation of the transverse colon with superficial ulceration. The megacolon was unresponsive to nasogastric suction, corticosteroids, antibiotics, and total parenteral nutrition. Arteriograms revealed total occlusion of the celiac axis and superior and inferior mesenteric arteries. Laparotomy showed encasement of the retroperitoneal vessels by dense fibrous tissue. A vascular bypass graft was performed, connecting the distal superior mesenteric artery to the right external iliac artery. This led to complete and lasting resolution of gastrointestinal complaints.