Cowpox in zoo and wild animals in the United Kingdom.

Cowpox virus is considered to be a re-emerging zoonotic pathogen and a public health threat due to increasing numbers of cases in humans and animals in Europe over the past decade, including within the United Kingdom (UK). We present epidemiological data and diagnostic features of 27 recent, naturally occurring cowpox cases in zoo and wild animals across the UK, including the first reports of cowpox in two snow leopards (Panthera uncia), a Bengal tiger (Panthera tigris tigris), three Chilean pudus (Pudu puda), a Malayan tapir (Tapirus indicus) and a Eurasian otter (Lutra lutra), and the first reports of Orthopoxvirus infection in a lar gibbon (Hylobates lar), a Southern tamandua (Tamandua tetradactyla) and an aardvark (Orycteropus afer). This study provides a detailed overview of cowpox infections in a wide range of non-domestic animal species, presents a range of methods for diagnosis and demonstrates the value of retrospective analysis of pathology surveillance in revealing epidemiological links.

A paleodemographic assessment of mortality and fertility rates during the second demographic transition in rural central Indiana.

Objectives: Since its inception, skeletally based paleodemographic research has emphasized the utility of biocultural models for interpreting the dynamic relationship between the sociocultural and ecological forces accompanying demographic transitions and shaping populations' health and well-being. While the demographic transition associated with the Neolithic Revolution has been a common focus in bioarcheology, the present study analyzes human skeletal remains from a large 19th century cemetery in central Indiana to examine population dynamics during the second demographic transition, a period generally characterized by decreasing fertility rates and improvements in life expectancy. This study demonstrates the potential to methodologically identify regional variations in the timing and interactions between broad-scale socioeconomic changes and technological advancements that characterized the time period through observed changes in survivorship and fertility based on age-at-death distributions.

Use of Next Generation Sequencing to study two cowpox virus outbreaks.

Background: Between 2008 and 2011 about 40 cases of human cowpox were reported from Germany and France. Infections had been acquired via close contact to infected, young pet rats. An identical and unique sequence of the hemagglutinin gene was found in various cowpox virus (CPXV) isolates pointing to a common source of infection.

Cowpox virus: What's in a Name?

Traditionally, virus taxonomy relied on phenotypic properties; however, a sequence-based virus taxonomy has become essential since the recent requirement of a species to exhibit monophyly. The species has failed to meet this requirement, necessitating a reexamination of this species. Here, we report the genomic sequences of nine and, by combining them with the available data of 37 additional genomes, confirm polyphyly of and find statistical support based on genetic data for more than a dozen species.

Complete Genome Sequence of the Embu Virus Strain SPAn880.

We report the complete genome sequence of the Embu virus. The genome consists of 185,139 bp and is nearly identical to that of the Cotia virus. This is the first report on the Embu virus genome sequence, which has been considered an unclassified poxvirus until now.

Endoscopic choroid plexus coagulation in infants with hydranencephaly or hydrocephalus with a minimal cortical mantle.

Background/aims: This study evaluates endoscopic choroid plexus coagulation, in conjunction with third ventriculostomy when technically feasible, as a strategy to treat patients with hydranencephaly or hydrocephalus with a minimal cortical mantle.

Methods: We retrospectively reviewed patients with hydranencephaly (n = 4) or hydrocephalus with the cortical mantle <1 cm in maximal thickness (n = 4) who underwent endoscopic choroid plexus coagulation from 2007 to 2010. Endoscopic third ventriculostomy was performed simultaneously when technically feasible (in 3 of 8 patients).

Lymphocytic hypophysitis in a patient presenting with sequential episodes of optic neuritis.

A 41-year-old man presented with left optic neuritis (ON) without evidence of other autoimmune disease or hormonal imbalance. MRI showed enlargement of the left optic nerve but no sellar lesion. The patient recovered after steroid therapy but later developed right ON and required treatment again.

Malignant transformation of an optic pathway glioma without prior radiation therapy.

Optic pathway gliomas (OPGs) arise from the optic nerves, optic chiasm, and/or hypothalamus and most commonly occur in childhood. Although these tumors can be quite challenging to manage, they are typically low-grade astrocytomas histologically, most commonly pilocytic astrocytomas. The few previously reported cases of malignant degeneration of an OPG occurred after external beam radiation therapy.

Isolation and molecular characterization of a tick-borne encephalitis virus strain from a new tick-borne encephalitis focus with severe cases in Bavaria, Germany.

Tick-borne encephalitis (TBE) is the most important viral infection transmitted by ticks in Central Europe. In Germany, where TBE was classified as a notifiable disease in 2001, a highly variable number of clinically apparent human cases was reported in the last few years, ranging from the lowest number of 238 in 2007 to a maximum of 546 in 2006. The dynamics of the virus and its vector tick remain poorly understood.

Outcomes and management strategies after nondiagnostic stereotactic biopsies of brain lesions.

Background/aims: A significant minority of stereotactic biopsies (SBs) of brain lesions is nondiagnostic, yet there are no optimal strategies for preventing nondiagnostic SB (NDSB) and for managing patients after NDSB. We performed this study in order to identify risk factors for NDSB, to determine how diagnoses are eventually reached in these patients, and to ascertain whether NDSB affects clinical outcomes.

Methods: Retrospective chart review of patients at our institution who underwent SB of brain lesions.

Cardiopulmonary resuscitation in patients with a Nuss bar--a case report and review of the literature.

Pectus excavatum (PE) is a common chest wall deformity that may produce a variety of physiological and psychological effects in children and adolescents. In addition, some of these patients have associated cardiac diseases (ie, mitral valve prolapse and Marfan syndrome). Recently, a minimally invasive surgical repair of PE that requires sternal bar placement has become increasingly frequent to enhance patients' cardiopulmonary functioning as well as their self-esteem.

Dynamic assessment of angiogenesis in renal cell carcinoma spheroids by intravital microscopy.

Purpose: Renal cell cancer represents a suitable tumor model for in vivo observation of neo-angiogenesis. We used intravital microscopy and the well established dorsal skin fold chamber model to characterize neo-angiogenesis in freely implanted renal cell cancer spheroids.

Material And Methods: Tumor spheroids were implanted into dorsal skin fold chambers of 8 nude mice.

Outcome after repair of congenital penile malformations.

Penile malformations seen and treated during childhood may result in voiding disorders and sexual malfunction in adults. Preputial synechia and phimosis will seldom be the reason for these problems, although some men do seek treatment to correct radical circumcision. Little is known about the satisfaction of men with neonatal or childhood circumcision.

Dual-phase helical CT of the kidney: value of the corticomedullary and nephrographic phase for evaluation of renal lesions and preoperative staging of renal cell carcinoma.

Objective: Our objective was to evaluate early-phase unenhanced and late-phase contrast-enhanced helical CT in revealing renal lesions and staging renal cell carcinomas.

Subjects And Methods: Contrast-enhanced helical CT of the kidneys was performed in 145 patients who also underwent unenhanced CT. Contrast-enhanced CT was performed in the corticomedullary phase (CMP) and nephrographic phase (NP).

Staging problems in the pre-operative chemotherapy of Wilms' tumour.

Objective: To determine the effect of the International Society of Paediatric Oncology (SIOP) Wilms' tumour protocols (pre-operative chemotherapy based on clinical and radiological findings, with no prior tumour verification by open or needle biopsy) on subsequent intra-operative tumour diagnosis and staging.

Patients And Methods: The diagnosis and staging of possible Wilms' tumour by clinical, ultrasonographic and radiological assessment were compared with the intra-operative findings in 14 consecutive children (1-12 years of age) treated between 1989 and 1994.

Results: A diagnosis of Wilms' tumour was histologically verified in 11 of 14 children.

Technique to improve surveying in confined areas.

Current surveying instrumentation precludes the thorough analysis of some areas of cast topography. The use of readily available, supplemental instrumentation when casts are surveyed will enhance removable partial denture therapy. In particular, facial embrasures and rest seats can be advantageously studied with this modified technique.

Mechanical assessment of interocclusal clearance.

Appropriate design considerations for pediatric or adult appliances are a part of diagnosis as well as therapy. These include occlusal factors. The occlusal considerations warrant accurately accommodating the cast metal framework or wire elements of a removable appliance.

Wilms tumor: the problem of diagnostic accuracy in children undergoing preoperative chemotherapy without histological tumor verification.

From 1989 to 1992, 9 consecutive children with a tentative diagnosis of Wilms tumor underwent therapy planned according to the International Society of Pediatric Oncology (SIOP)-9 Wilms tumor protocol, including preoperative chemotherapy. Because tumor biopsy is not recommended in this SIOP-9 protocol due to a possible tumor spread from open or needle biopsy, diagnostic accuracy is mandatory. We present our problems in diagnostic accuracy resulting in withdrawal of 2 children from preoperative chemotherapy, understaging the tumor in 2 and missing exact tumor histology due to complete tumor necrosis in 2.

Bone marrow immunoscintigraphy versus conventional bone scintigraphy in the diagnosis of skeletal metastases in urogenital malignancies.

Bone marrow immunoscintigraphy using a 99mTc-labelled anti-NCA-95 monoclonal antibody and conventional bone scintigraphy with 99mTc-methylene-diphosphonate were compared in the diagnosis of skeletal metastases in 58 patients with urogenital tumours. In 13 patients with metastatic disease, bone marrow immunoscintigraphy proved to be superior to bone scintigraphy, detecting 431 metastatic lesions on immunoscans as compared to 261 lesions on bone scans. However, on a patient-by-patient basis bone marrow immunoscintigraphy did not demonstrate a clinical advantage over conventional bone scanning, as in this study no patient was identified with metastatic disease still confined to the marrow space, with bone scintigraphy and bone X-ray being normal.

Digital radiography in urologic imaging: radiation dose reduction on urethrocystography.

Digital luminescent radiography (DLR) is a new form of digital radiographic technology which can be used as an alternative to conventional radiologic systems; it replaces conventional screen-film systems by photostimulable phosphorus. Due to the linear dynamic range of photostimulable phosphorus, x-ray examinations can be performed with significantly lower radiation exposure. In this study radiation dose was reduced by about 90% using DLR for urethrocystography.

Color-coded duplex sonography for diagnosis of testicular torsion.

By color-coded duplex sonography moving structures are visualized as red or blue colors within a normal gray-scale B-mode ultrasound image. Thus, blood flow even within small vessels can be visualized clearly. Color-coded duplex sonographic examination was performed in 11 patients who presented with scrotal pain.

Metallic dental restorations. A performance survey.

A radiographic survey was conducted to assess professional performance in restorative dentistry. Analysis of 629 proximal metallic margins of restorations revealed a significant level of imperfection. The discrepancies at the gingival margins were measured on a tracing of the restoration using a grid and a Boley gauge.