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The Scottish Beaver Trial (SBT) reintroduced the Eurasian beaver (

Hantaviruses are RNA viruses (order Bunyavirales, family Hantaviridae) found in rodent, bat and insectivore reservoir-hosts and have been reported as an emerging significant zoonotic risk in Europe. As part of two native semiaquatic rodent restoration projects, tissue and urine samples were tested for hantavirus from water voles (Arvicola amphibius) (n=26, in 2015) and Eurasian beavers (Castor fiber) (n=20, covering 2010-2015) using a pan-hantavirus nested real-time PCR test. Kidney and lung samples were also analysed by light microscopy after haematoxylin and eosin staining of formalin-fixed paraffin wax sections. Individuals selected included those forming the source of release animals and from those already free-living in Britain in areas targeted for release, to identify existing reservoirs. For water voles all tested individuals were from Britain (n=26); for beavers some were from Britain (Scotland) (n=9) and some were samples from wild Norwegian (Telemark region) (n=6) and German (Bavaria region) animals (n=5) that formed the source of accepted wild populations currently present in Scotland. All samples tested from both species were negative for hantavirus RNA and showed no significant histopathological changes suggesting that reservoir infection with hantavirus in water voles in Britain and Eurasian beavers present in Britain, Norway and Bavaria, Germany, is unlikely.

The Scottish Beaver Trial (SBT) reintroduced the Eurasian beaver (Castor fiber) in 2009 using wild-caught Norwegian beavers. This included a six-month prerelease quarantine in Devon, England. The International Union for Conservation of Nature (IUCN) and government guidelines for health screening were followed, including testing for Leptospira species. Unlicensed beavers, from Germany, were also identified in Scotland (Tayside) and Devon (later forming the River Otter Beaver Trial (ROBT)) and were health-screened under licence. Due to positive Leptospira species results and lack of prerelease screening in ROBT and Tayside, beavers from Germany and Norway (range sources) were screened. One hundred and fifty-six samples from 151 beavers were analysed by Leptospira species quantitative PCR (qPCR) (n=73 kidney (postmortem)/urine samples (antemortem)) or microscopic agglutination test (MAT, Leptospira pools 1–6) (n=83 serum samples). No beavers from Norway (95 per cent confidence interval (CI) 0–5.6 per cent, n=52), Tayside or SBT postrelease (95 per cent CI 0–4.6 per cent, n=63) tested positive. Seven beavers from Germany and Devon were positive. This gives an overall 9.3 per cent (95 per cent CI 5.2-15.1 per cent) exposure level, of which 4.6 per cent (95 per cent CI 1.9-9.3 per cent) suggested infection on a positive qPCR (n=1) or MAT titre of at least 1/400 (n=6), although none had abnormal physical, biochemical or haematological changes. This study suggests that Leptospira species infection in wild Eurasian beavers occurs at a low level, has no sex bias and does not appear to cause significant morbidity or mortality.

BACKGROUND: Diabetes mellitus (DM) and gastroesophageal reflux disease (GERD) are characterized by a rapidly increasing incidence within the Western World causing incredible costs. DM affects about 10% of the population, whereas GERD symptoms and GERD related esophagitis have been reported in 40% and 20%, respectively. METHODS: This systematic review deals with the current knowledge on GERD in diabetic patients with special reference to symptoms, diagnostic outcomes, pathophysiologic characteristics and treatment strategies. The evidence level is low, as most of the contributions are individual case-control studies with limited number of patients (evidence level IIIb) and case series (evidence level IV). RESULTS: GERD symptoms are found in about 50% of diabetics being most pronounced among those taking oral hypoglycaemic agents. Prolonged duration of diabetes, low glycaemic control with increased HbA1c levels and obesity intensify these complaints. Erosive esophagitis affects more than 40% of diabetics, with a higher prevalence for those suffering from autonomic neuropathy. PH-metric abnormalities have been documented in up to 90% of diabetics with symptomatic GERD, whereas manometric findings are conflicting. Altered gastric acid, bicarbonate and salivary secretion, increased rates of transient lower esophageal sphincter relaxations and a hypotensive lower esophageal sphincter contribute to the genesis of GERD besides impaired esophageal and gastric peristalsis. Moreover, diabetic conditions cause delayed healing of mucosal injury. No data have been available on the effects of proton pump inhibitors in diabetic GERD patients, and there are no studies dealing with interventional or surgical treatment of these patients. CONCLUSIONS: There is some evidence that diabetes is an independent risk factor for the development of GERD not directly associated with obesity. Distinct pathophysiologic mechanisms are of importance for the genesis of GERD in diabetics raising the need for further studies.

Medical and surgical treatment are able to improve symptoms in patients with gastroesophageal reflux disease (GERD). The aim of this study was to evaluate the outcome following laparoscopic antireflux surgery in GERD patients with primary respiratory-related symptoms and to investigate the quality of life index before and after therapy. Three hundred thirty-eight consecutive patients underwent surgical treatment for GERD-induced symptoms. Of this group 126 patients had primary respiratory symptoms related to GERD. All patients were studied by means of a symptom questionnaire, endoscopy, esophageal manometry, 24-hour esophageal pH monitoring, and a barium esophagogram. In addition, the quality of life was measured by the means of the Gastrointestinal Quality of Life Index (GIQLI). All patients had medical therapy with proton pump inhibitors preoperatively. A laparoscopic fundoplication was performed in all patients. The outcome was assessed 3 and 12 months postoperatively. Following surgery, all respiratory symptoms were significantly improved. While GIQLI was highly impaired before surgical therapy, a significant improvement of quality of life was obtained. Because medical treatment is likely to fail in GERD patients with respiratory symptoms, the need for surgery arises and may be the only successful treatment in the long term. Quality of life was significantly improved by surgical treatment.

Laparoscopic Nissen fundoplication (LNF) has evolved as a gold standard in antireflux surgery. However, the association between body weight and gastroesophageal reflux disease (GERD) is still unclear, and no data are available concerning the effect of fundoplication on body weight. We present the first report elucidating the impact of LNF on body weight in GERD patients with special emphasis on patients’ quality of life. From July 2000 to March 2003, LNF was carried out in 213 patients (85 women and 128 men) after thorough preoperative examination including clinical interview with standardized assessment of symptoms and quality of life (QoL), endosocopy, barium swallow, 24-h pH-metry, and manometry. Follow-up investigations were performed 3 and 12 months after LNF obtainable from 209 patients (98.1%) and 154 patients (72.3%), respectively. The mean body mass index (BMI) decreased significantly after LNF (27.6 ± 5.6 kg/m2 before LNF vs 26.0 ± 3.8 kg/m2 after LNF, p < 0.001). Twelve months after LNF, neither a tendency toward a renewed increase nor a further decrease in BMI was observable. The average body weight loss was 3.9 kg. BMI reduction was higher in women than in men (p < 0.002), and obese patients lost more weight than lean patients (p < 0.001). There was no association between BMI reduction and dysphagia. Plasma cholesterol and triglyceride levels did not change after LNF. The mean general score of the Gastrointestinal Quality of Life Index markedly improved (90.1 ± 21.3 before LNF vs 118.0 ± 16.2 after LNF, p < 0.01), as did the GERD-Health Related Quality of Life Index (21.9 ± 6.4 before LNF vs 3.5 ± 2.7 after LNF, p < 0.001). However, there was no association between changes in BMI and QoL. LNF leads to significant and persistent body weight loss.

Beavers do not exhibit any external sexual trait. Therefore, a simple method was established to differentiate between males and females by verifying the male-specific SRY gene. Genomic DNA was prepared from hair root cells. Male samples displayed an electrophoretic 157-bp band derived from the SRY gene after polymerase chain reaction (PCR) amplification. This band is missing in female samples. A 375-bp fragment of the mitochondrial cytochrome b gene served as internal control and was visible in all samples. The technique can easily be used as a standard monitoring method, and is noninvasive, quick, and reliable. Zoo Biol 21:305–308, 2002. © 2002 Wiley-Liss, Inc.

The aim of the study was to develop a simple and reliable method for differentiation of the two phenotypic, very similar Eurasian and North American beavers. Hair bulbs were plucked as tissue samples from the fur of living animals. The mitochondrial cytochrome b locus was amplified by polymerase chain reaction and sequenced. The fragments of the two species differed at 44/41 nucleotide sites. RsaI recognised two mutations, resulting in a restriction fragment length polymorphism that seems to be species specific, as could be revealed by the banding pattern. Zoo Biol 19:511-515, 2000. Copyright 2000 Wiley-Liss, Inc.

The Dieulafoy lesion is a rare cause of severe gastrointestinal hemorrhage. The lesion is usually located in the stomach, although it may occur anywhere in the gastrointestinal tract. We describe four patients with extragastric Dieulafoy's disease, in the duodenum (one), the proximal jejunum (two), and the left hemicolon (one). Diagnosis was made by endoscopy in all four and confirmed by histology in three. The pathology of the Dieulafoy lesion is essentially the same throughout the gastrointestinal tract. Endoscopic treatment by sclerotherapy combined with electrocoagulation was successful in the duodenal and colonic Dieulafoy lesions, but not in the jejunal lesions.

Epithelial dysplasia in the gastric remnant is generally considered to have a positive predictive value for malignancy. Whether dysplasia progresses to carcinoma or whether both just have a common origin, is still a matter of controversy. The aim of the present study in rats was to investigate the natural history of epithelial lesions in the gastric remnant. A gastric resection was carried out in 50 male Wistar rats. Postoperatively the animals received N-methyl-N'-nitro-N-nitrosoguanidine orally. Gastroscopy was carried out monthly and biopsies were taken for histologic evaluation. The rats were killed after 12 months or if gastric cancer was found on gastroscopy. Twenty-four rats died postoperatively and were excluded from the study. A total of 228 gastroscopies was performed in the remaining 26 animals; 24 animals developed dysplastic lesions during the follow-up period. The rate of development of gastric cancer within one month increased with the stage of dysplasia at the previous examination (3% for mild, 48% for moderate, 100% for severe dysplasia). There was a strong correlation between the time period following gastric resection and grade of dysplasia and between the grade of dysplasia and development of cancer. Our study demonstrates that gastric stump cancer in rats develops from dysplastic lesions. A dysplasia-carcinoma sequence can therefore be assumed.

Primary squamous cell carcinoma (SCC) of the stomach is extremely rare and thought to arise from ectopic squamous epithelium, which in turn could either result from the squamous metaplasia of the gastric mucosa or be congenital in origin. We report herein a case of SCC of the stomach in a 17-year-old male, who died 1 year after undergoing a gastrectomy. To our knowledge, this is the youngest case of primary SCC of the stomach reported in the literature. Further speculative possibilities of the development of primary gastric SCC are discussed following the presentation of this case.

A new method of orotracheal intubation in rats which was developed to prevent apnea during upper gastrointestinal endoscopiy is described. After the anesthetized animals are relaxed with an I. V. injection of Vecuronium, orotracheal intubation was performed with a thin endoscope under complete visual control. After relaxation is achieved the glottis is wide open and intubation can be performed carefully without any medianical irritation of the larynx. After placement of the tube in the trachea, the fiberoptic was removed and pressure–controlled ventilation occurred. This technique can be widely applied in any kind of rat experiment, where controlled ventilation is required.

The quantitative nuclear DNA content of nuclei from fine needle aspirations from 70 patients with pancreatic cancer was measured using an image analyser system. Retrospective analysis of patients indicated that cases with tumour stemlines in the diploid region had the best chance for radical surgery (p less than 0.006) and the best probability of survival (p less than 0.0004). The prognosis for patients with tetraploid stemlines was intermediate and was poorest for patients with no stemlines in the diploid-tetraploid region. From those parameters assessed postoperatively, only the tumour stage added appreciable information on prognosis to the preoperative quantitative DNA content obtainable. Therefore, in patients with pancreatic cancer the quantitative DNA content should be taken into account in planning treatment and assessing prognosis. Furthermore, the quantitative DNA content may have a major role in stratification for further treatment trials.

The nuclear DNA distribution pattern of the neoplastic parenchymal cells of 100 conventionally formalin-fixed and paraffin-embedded specimens from pancreatic adenocarcinomas and from 8 specimens of chronic pancreatitis was assessed by means of image cytometry. All material originated from pancreatic resections. Evaluable DNA histograms could be obtained for 77 carcinomas, and clinical data were available for 71 of these. In these 71 specimens, the nuclear DNA ploidy pattern was also investigated by means of flow cytometry. In 76 of the 77 cases, the image-cytometric DNA ploidy pattern obtained showed a "nondiploid" distribution with modal values as high as 8.5 c. In 21 cases, the neoplastic cells showed modal values in the "triploid" region. The analogous 71 flow-cytometric DNA histograms could only be evaluated in 50 cases because of excessively high amounts of background and/or excessively broad peaks. In 47 cases, the nuclear DNA histogram was nondiploid according to both techniques. The patients with carcinomas whose cell nuclei showed a triploid DNA distribution showed a significantly shorter survival time than those with tumor cell populations of nontriploid DNA distribution patterns. In the 8 specimens of chronic pancreatitis, the parenchymal cells were all equipped with nuclei showing diploid DNA distribution patterns.

Background: By application of a newly developed device for invasive pressure measurements, we have investigated band adjustments monitored by in vivo intraband pressures. With access to the port of the gastric banding device, pressures can be recorded inside the band system at rest and during bolus application with different adjustments of the band. Methods: 25 patients (mean age 38.7, mean BMI 45.1, 80% women) had intraband pressure measurements at the first band adjustment 8.2 weeks (range 6 to 17) postoperatively. For this purpose, we adapted a pressure monitoring system with the TruWave disposable pressure transducer of Edwards®. All patients underwent gastric banding using the Swedish adjustable gastric band (SAGB) by the pars flaccida technique. Results: In vivo intraband pressures differ from ex vivo intraband pressures. With increasing fill volume in vivo measurements show increasingly higher pressures than ex vivo measurements. This difference can mainly be attributed to the influence of the enclosed tissue. The in vivo intraband pressures correlate with the amount of outflow obstruction. Conclusion: Intraband pressure measurement is an encouraging new access to gastric banding. It appears to be a feasible method to control band adjustment without need for x-ray studies in low pressure bands. We expect physiologically exact adjustments to achieve good weight loss and to prevent esophageal problems in the long term.

The aim of the study was to develop a simple and reliable method for differentiation of the two phenotypic, very similar Eurasian and North American beavers. Hair bulbs were plucked as tissue samples from the fur of living animals. The mitochondrial cytochrome b locus was amplified by polymerase chain reaction and sequenced. The fragments of the two species differed at 44/41 nucleotide sites. RsaI recognised two mutations, resulting in a restriction fragment length polymorphism that seems to be species specific, as could be revealed by the banding pattern. Zoo Biol 19:511-515, 2000. Copyright 2000 Wiley-Liss, Inc.

It is not known whether antireflux surgery is more effective than medical therapy to control respiratory symptoms (RS) in gastroesophageal reflux disease (GERD).In 21 GERD patients with RS, reflux was assessed by endoscopy, manometry, and pH monitoring. Patients had proton pump inhibitor therapy and cisapride for 6 months. After GERD relapsed following withdrawal of medical therapy, 7 patients with normal esophageal peristalsis had a laparoscopic Nissen fundoplication and 14 with impaired peristalsis a Toupet fundoplication. Respiratory symptoms were scored prior to treatment, at 6 months following medical therapy, and at 6 months after surgery.Heartburn and esophagitis were effectively treated by medical and surgical therapy. Only surgery improved regurgitation. Respiratory symptoms improved in 18 patients (85.7%) following surgery and in only 3 patients (14.3%) following medical therapy (P0.05). Esophageal peristalsis improved following the Toupet fundoplication.Medical therapy fails to control reflux since it does not inhibit regurgitation. Surgery controls reflux and improves esophageal peristalsis, which contributes to its superiority over medical therapy in the treatment of RS associated with GERD.

The frequency of Ki-ras gene mutations was studied in 100 paraffin-embedded sections obtained from 63 pancreatic adenocarcinomas by in vitro amplification of target sequences via polymerase chain reaction (PCR) and selective oligonucleotide hybridization. Forty-seven (75%) of the tumors contained a Ki-ras mutation at codon 12. No predominant amino acid substitution or nucleotide transition at this codon was observed. Two carcinomas exhibited 2 distinct Ki-ras mutations. No particular correlation could be established between the incidence of Ki-ras mutation and clinical parameters (sex, age, survival), tumor grade or tumor stage.

Summary Deparaffinized and disintegrated material from conventionally formalin-fixed and paraffin-embedded surgical specimens of 10O cases of ductal adenocarcinoma of the pancreas was Feulgom-stained, and the cytochemical DNA distribution patterns of at least 100 single tumour cells and 5O “control” cells (fibrocytes) were assessed by means of image cytometry (ICM). In 77 cases a sufficient number of neoplastic cells could be obtained for these DNA assessments. The fairly high number (23) of cases that had to be excluded due to too small amounts of disintegpated cells or cell nuclei may be explained by the high content of connective tissue stroma in these pancreatic adenocarcinomas. The tumour cell nuclei in 76 of these 77 cases showed cytochemically a clear-cut “non-diploid” DNA distribution pattern. This observation reflects the well-known highly malignant growth potential of this carcrinoma. Despite the fact that about 1/4 ofthe tumours had to be excluded, the main result of our methodological study is, after all that conventionally formalin-fixed paraffin-embedded specimens of most pancreatic adenocarcinomas can be successfully used for the deparaffinization-disintegration procedure preceding the nuclear DNA assessments by means of ICM Additional studies are, however, required to obtain the diagnostic and prognostic impact of the results of such cytochemical analyses of the DNA distribution pattern in adenocarcinomas of the pancreas.