Management of lower limb ischaemia associated with the use of intra-aortic balloon pumps during cardiac surgery

Objective:To audit the lower limb vascular complications associated with the use of an intraaortic balloon pump (IABP) on a cardiothoracic unit over a 12 month period.Design:Retrospective analysis.Setting:Regional university cardiothoracic unit.Patients:Fifty four IABPs inserted into 51 patients.Results:Seventeen patients (33%) died from cardiogenic shock in the immediate postoperative period. Of the remaining 34 patients (37 IABPs), lower limb vascular complications occurred in nine patients (26%) who underwent 11 IABP insertions (30%). Vascular complications included groin haematomas (n = 2 insertions), compartment syndrome (n = 2 insertions), femoral artery trauma (n = 7 insertions).Conclusions:Prompt management by peripheral vascular surgeons resulted in limb salvage in 10 legs and only one death from a pulmonary embolus

Characterization of ERG, AR and PTEN gene status in circulating tumor cells from patients with castration-resistant prostate cancer

Hormone-driven expression of the ERG oncogene after fusion with TMPRSS2 occurs in 30% to 70% of therapy-naive prostate cancers. Its relevance in castration-resistant prostate cancer (CRPC) remains controversial as ERG is not expressed in some TMPRSS2-ERG androgen-independent xenograft models. However, unlike these models, CRPC patients have an increasing prostate-specific antigen, indicating active androgen receptor signaling. Here, we collected blood every month from 89 patients (54 chemotherapy-naive patients and 35 docetaxel-treated patients) treated in phase I/phase II clinical trials of an orally available, highly specific CYP17 inhibitor, abiraterone acetate, that ablates the synthesis of androgens and estrogens that drive TMPRSS2-ERG fusions. We isolated circulating tumor cells (CTC) by anti-epithelial cell adhesion molecule immunomagnetic selection followed by cytokeratin and CD45 immunofluorescence and 4',6diamidino-2-phenylindole staining. We used multicolor fluorescence in situ hybridization to show that CRPC CTCs, metastases, and prostate tissue invariably had the same ERG gene status as therapy-naive tumors (n = 31). We then used quantitative reverse transcription-PCR to show that ERG expression was maintained in CRPC. We also observed homogeneity in ERG gene rearrangement status in CTCs (n = 48) in contrast to significant heterogeneity of AR copy number gain and PTEN loss, suggesting that rearrangement of ERG may be an earlier event in prostate carcinogenesis. We finally report a significant association between ERG rearrangements in therapy-naive tumors, CRPCs, and CTCs and magnitude of prostate-specific antigen decline (P = 0.007) in CRPC patients treated with abiraterone acetate. These data confirm that CTCs are malignant in origin and indicate that hormone-regulated expressio

Pelvic floor and colonic function in multiple sclerosis and faecal incontinence

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN005061 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

A Wavelet Optimized Adaptive Multi-Domain Method

The formulation and implementation of wavelet based methods for the solution of multidimensional partial differential equations in complex geometries is discussed. Utilizing the close connection between Daubechies wavelets and finite difference methods on arbitrary grids, we formulate a wavelet based collocation method, well suited for dealing with general boundary conditions and nonlinearities. To circumvent problems associated with completely arbitrary grids and complex geometries, we propose to use a multi-domain formulation to solve the partial differential equation, with the ability to adapt the grid as well as the order of the scheme within each subdomain. In addition to supplying the required geometric flexibility, the multi-domain formulation also provides a very natural load-balanced data-decomposition, suitable for parallel environments. The performance of the overall scheme is illustrated by solving two dimensional hyperbolic problems

A Wavelet Optimized Adaptive Multi-Domain Method

The formulation and implementation of wavelet based methods for the solution of multidimensional partial differential equations in complex geometries is discussed. Utilizing the close connection between Daubechies wavelets and finite difference methods on arbitrary grids, we formulate a wavelet based collocation method, well suited for dealing with general boundary conditions and nonlinearities. To circumvent problems associated with completely arbitrary grids and complex geometries we propose to use a multi-domain formulation in which to solve the partial differential equation, with the ability to adapt the grid as well as the order of the scheme within each subdomain. Besides from supplying the required geometric flexibility, the multi-domain formulation also provides a very natural load-balanced data-decomposition, suitable for parallel environments. The performance of the overall scheme is illustrated by solving two dimensional hyperbolic problems. This research was partially sup..

The UKIRT infrared deep sky survey first data release

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