Atraumatic Clostridium septicum myonecrosis presenting as upper limb ischaemia in a patient with undiagnosed bowel cancer.

Necrotising infections remain challenging to surgeons, both in diagnosis and management. Timely recognition and treatment remain vital. We report a presentation of limb ischaemia with no apparent precipitating factors, in a systemically stable patient, due to atraumatic Clostridium septicum myonecrosis. This article demonstrates the use of rapid cross-sectional imaging in finding an undiagnosed bowel cancer as a basis for this type of infection. Rapid cross-sectional imaging may be utilised where there is doubt about the underlying pathology of upper limb ischaemia. Patients whose cultures grow Clostridium septicum must be investigated for malignancy.

Characteristics of the turbulence in the flow at a tidal stream power site.

This paper analyses a set of velocity time histories which were obtained at a fixed point in the bottom boundary layer of a tidal stream, 5 m from the seabed, and where the mean flow reached 2.5 m s(-1). Considering two complete tidal cycles near spring tide, the streamwise turbulence intensity during non-slack flow was found to be approximately 12-13%, varying slightly between flood and ebb tides. The ratio of the streamwise turbulence intensity to that of the transverse and vertical intensities is typically 1 : 0.75 : 0.56, respectively. Velocity autospectra computed near maximum flood tidal flow conditions exhibit an f(-2/3) inertial subrange and conform reasonably well to atmospheric turbulence spectral models. Local isotropy is observed between the streamwise and transverse spectra at reduced frequencies of f>0.5. The streamwise integral time scales and length scales of turbulence at maximum flow are approximately 6 s and 11-14 m, respectively, and exhibit a relatively large degree of scatter. They are also typically much greater in magnitude than the transverse and vertical components. The findings are intended to increase the levels of confidence within the tidal energy industry of the characteristics of the higher frequency components of the onset flow, and subsequently lead to more realistic performance and loading predictions.

Evaluation of novel renal biomarkers with a cisplatin model of kidney injury: gender and dosage differences.

A number of novel urinary biomarkers have been identified and partially qualified for use as markers for renal injury in rats. We use two novel multiplex assays to quantify biomarker concentration in multiple urine collections made prior to and following administration of cisplatin, a common nephrotoxicant, to rats. We investigate the correlation of the magnitude of biomarker changes with the severity of histopathological observations and explore the relationship of these to both dose and sex. The novel biomarkers evaluated are urinary albumin, alpha glutathione s-transferase (α-GST), glutathione S-transferase-yb1 (GSTYb1), lipocalin-2, kidney injury molecule-1 (KIM-1), osteopontin, and renal papillary antigen 1 (RPA-1) and plasma cystatin C, alongside the traditional biomarkers of plasma urea, creatinine, and urinary n-acetyl-beta-d-glucosaminidase (NAG), total protein, and glucose. We show for all time points, and for almost all doses, that male rats consistently had either more severely graded or a higher incidence of histologically observed lesions than females; that changes in urinary glucose, total urinary protein, NAG, and the novel urinary biomarkers albumin, osteopontin, and KIM-1 are clearly temporally associated; and that changes are related to the severity of injury. We also found that receiver operating characteristic curve analysis and area under the curve are significantly higher than urea or creatinine for all new biomarkers except aGST, GSTYb1, cystatin c, and total protein in both sexes.