Repeated successful surgical rescues of early and delayed multiple ruptures of ventricular septum, right ventricle and aneurysmal left ventricle following massive biventricular infarction

A 58 year old man underwent 6 surgical interventions for various complications of massive biventricular myocardial infarction over a period of 2 years following acute occlusion of a possibly "hyperdominant" left anterior descending coronary artery. These included concomitant repair of apicoanterior post-infarction VSD and right ventricular free wall rupture, repeat repair of recurrent VSD following inferoposterior extension of VSD in the infarcted septum 5 weeks later, repair of delayed right ventricular free wall rupture 4 weeks subsequently, repair of a bleeding left ventricular aneurysm eroding through left chest wall 16 months thereafter, repair of right upper lobe lung tear causing massive anterior mediastinal haemorrhage, mimicking yet another cardiac rupture, 2 months later, followed, at the same admission, 2 weeks later, by sternal reconstruction for dehisced and infected sternum using pedicled myocutaneous latissimus dorsi flap. 5 years after the latissimus myoplasty, the patient remains in NYHA class 1 and is leading a normal life

Surface mass balance and stable oxygen isotope ratios from shallow firn cores on Fimbulisen, East Antarctica

The mass balance of Antarctica is one of the crucial factors for determining sea-level change in a warming climate. The marginal zones of the continent, namely the ice shelves, are most sensitive to climate change. During the 2009/10 austral summer an extensive glaciological field campaign was carried out on Fimbulisen, an ice shelf in East Antarctica, to investigate its recent surface mass balance. Shallow (10–18 m) firn cores were drilled and accumulation rates and stable-isotope ratios determined. For firn-core dating, two different methods were compared: (1) seasonal variations of stable oxygen isotope ratios (δ18O), and (2) dielectric profiling, including using the volcanic eruptions of Pinatubo, Philippines (1991), and El Chichόn, Mexico (1982), as time markers. The mean annual accumulation for the period 1992–2009 ranges from 298 to 349 mmw.e. a–1. The interannual variability at the drilling sites is >30%. Accumulation rates show a weak decreasing trend during the past 20–30 years, which is statistically significant only for one of the cores. Stable-isotope ratios were compared to the snowfall temperature of Neumayer station. Neither the temperatures nor the δ18O values show any trend for the investigated time period

Observations beneath Pine Island Glacier in West Antarctica and implications for its retreat

Thinning ice in West Antarctica, resulting from acceleration in the flow of outlet glaciers, is at present contributing about 10% of the observed rise in global sea level. Pine Island Glacier in particular has shown nearly continuous acceleration and thinning, throughout the short observational record. The floating ice shelf that forms where the glacier reaches the coast has been thinning rapidly, driven by changes in ocean heat transport beneath it. As a result, the line that separates grounded and floating ice has retreated inland. These events have been postulated as the cause for the inland thinning and acceleration. Here we report evidence gathered by an autonomous underwater vehicle operating beneath the ice shelf that Pine Island Glacier was recently grounded on a transverse ridge in the sea floor. Warm sea water now flows through a widening gap above the submarine ridge, rapidly melting the thick ice of the newly formed upstream half of the ice shelf. The present evolution of Pine Island Glacier is thus part of a longer-term trend that has moved the downstream limit of grounded ice inland by 30?km, into water that is 300?m deeper than over the ridge crest. The pace and ultimate extent of such potentially unstable retreat are central to the debate over the possibility of widespread ice-sheet collapse triggered by climate change