Dorsalis pedis artery aneurysm.

Aneurysm of the pedal arteries is uncommon. Dorsalis pedis aneurysms are a clinically rare phenomenon. We present a case of traumatic fusiform aneurysm of the dorsalis pedis artery in an otherwise well 53-year-old Caucasian man. Initial history was suggestive of micro-embolic disease to the medial toes of the left foot and on examination pulses were palpable throughout the lower limbs with a strong, palpable dorasalis pedis pulse. Ankle brachial pressure indexes were normal but reduced toe pressures to the left toes. Colour flow duplex imaging revealed aneurysmal dilation, involving all layers of artery wall, with irregular intraluminal thrombus across a 16-mm segment. Subsequent CTA run-off revealed all vessels were patent in the left lower limb. Due to concerns over further embolisation, our patient underwent successful ligation of the his dorsalis pedis. He had an uneventful post-operative recovery.

Risks and benefits of pasture irrigation using treated municipal effluent : a lysimeter case study, Canterbury, New Zealand.

Compared to discharge into waterways, land application of treated municipal effluent (TME) can reduce the need for both inorganic fertilizers and irrigation. However, TME irrigation may result in the accumulation of phosphorus (P) or trace elements in soil, and increased salinity and sodicity, which could damage soil structure and reduce infiltration. TME irrigation can also result in groundwater contamination through nitrate leaching or surface water contamination through runoff. This study aimed to evaluate the effects of increasing TME irrigation rates on quantity and quality of leachate and pasture growth in a lysimeter experiment using a Fluvial Recent soil and a Fragic Pallic soil. Pasture growth in the lysimeters was up to 2.5-fold higher in the TME treatments compared to the non-irrigated treatments. There were no signs of toxicity or accumulation of B, Al, Cd, Cu, Fe, Mn, As, and Zn. TME significantly increased the concentration of P and Na in the pasture. Nitrogen leaching from the lysimeters was negligible (< 1 kg/ha-1 equiv.) in all treatments, but mineral N accumulated in the soil profile of the highest application rate (1672 mm/yr). Although more P was added than removed in pasture, the rate of accumulation indicated that over a 50-year period, P will still be within the current New Zealand thresholds for grazed pastures. Sodium accumulated in the soil columns in all the TME treatments. The rate of accumulation was not proportional to the TME application rate, indicating that Na was moving down through the soil profile and leaching. Results indicate a low to moderate risk of sodicity in soil or toxicity in plants caused by Na.

Effective treatment of intractable cutaneous metastases of breast cancer with electrochemotherapy: Ten-year audit of single centre experience.

PURPOSE: Electrochemotherapy (ECT) is the application of electric pulses to tumour tissue to render the cell membranes permeable to usually impermeant hydrophilic anti-cancer drugs, thereby enhancing cytotoxic effects. We sought to ascertain whether ECT can be an effective palliative treatment for cutaneous metastases of breast cancer. METHODS: This work reports data from the European Standard Operating Procedures for Electrochemotherapy trial (EudraCT Number: 2004-002183-18). In combination with systemic and/or intratumoural bleomycin, optimised electric pulses were delivered to locally recurrent or metastatic cutaneous breast cancer lesions. Follow-up continued until December 2014. RESULTS: Between February 2004 and December 2014, twenty-four patients were treated. All patients had received prior multimodal therapy. In total, the patient cohort had, or developed, 242 lesions. Two hundred and 36 lesions were treated, with 34 lost to follow-up. An objective response was seen in 161 of 202 lesions (79.7%), with a complete response observed in 130 (64.3%). Thirty-nine lesions (19.3%) did not respond, while 2 (1%) progressed following ECT. 17 (73.9%) patients received two or fewer treatments. A minimum of a partial response was seen in at least 50% of treated lesions in 18 of the 24 (75%) patients. Smaller lesions were more likely to have an objective response (Chi-square test for trend, p < 0.001). CONCLUSIONS: Electrochemotherapy is an effective treatment for cutaneous breast cancer lesions that have proven refractory to standard therapies. As smaller lesions were found to be more responsive, we suggest that ECT should be considered as an early treatment modality, within multimodal treatment strategies.