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Objectives Several plaque and lesion characteristics have been associated with an increased risk for procedural stroke during or shortly after carotid artery stenting (CAS). While technical advancements in stent design and cerebral protection devices (CPD) may help reduce the procedural stroke risk, and anatomy remains important, tailoring stenting procedures according to plaque and lesion characteristics might be a useful strategy in reducing stroke associated with CAS. In this descriptive report of the ongoing Asymptomatic Carotid Surgery Trial-2 (ACST-2), it was assessed whether choice for stent and use or type of CPD was influenced by plaque and lesion characteristics. Materials and methods Trial patients who underwent CAS between 2008 and 2015 were included in this study. Chi-square statistics were used to study the effects of plaque echolucency, ipsilateral preocclusive disease (90–99%), and contralateral high-grade stenosis (>50%) or occlusion of the carotid artery on interventionalists' choice for stent and CPD. Differences in treatment preference between specialties were also analysed. Results In this study, 831 patients from 88 ACST-2 centres were included. Almost all procedures were performed by either interventional radiologists (50%) or vascular surgeons (45%). Plaque echolucency, ipsilateral preocclusive disease (90–99%), and significant contralateral stenosis (>50%) or occlusion did not affect the choice of stent or either the use of cerebral protection and type of CPD employed (i.e., filter/flow reversal). Vascular surgeons used a CPD significantly more often than interventional radiologists (98.6% vs. 76.3%; p < .001), but this choice did not appear to be dependent on patient characteristics. Conclusions In ACST-2, plaque characteristics and severity of stenosis did not primarily determine interventionalists' choice of stent or use or type of CPD, suggesting that other factors, such as vascular anatomy or personal and centre preference, may be more important. Stent and CPD use was highly heterogeneous among participating European centres.

Primary soft tissue reconstruction in complex leg injuries is mandatory in order to protect exposed tissues; however, it may be precluded by the patient's clinical status or by local wound conditions. This retrospective study aims to evaluate the use of negative pressure as an adjunct to delayed soft tissue reconstruction in patients with complex lower limb trauma.Forty-two patients with 49 complex lower limb injuries were treated with Vacuum assisted closure (VAC) 48 hours after bone fixation, vascular repair and surgical debridement. Wound swab cultures were obtained before and after every VAC application. Duration of therapy, wound flora, final reconstructive technique required, outcome and follow-up period were retrieved from medical records.Twenty-four male and eighteen female patients were recruited, with a mean age of 47 years. All were treated with VAC therapy for 15-42 days. Reconstruction was delayed due to the patients' critical condition, advanced age, medical co-morbidities, heavily exuding wounds and questionable viability of soft tissues. Patients were followed up for 90-895 days. Two wounds healed spontaneously, 6 were managed with delayed direct suture, 31 with split thickness skin grafts and 9 required local cutaneous, fasciocutaneous or muscular flaps. One patient died due to fat embolism. Wound bacterial flora progressively decreased in all but one patient. Scar formation was aesthetically acceptable by the patients while function depended on the initial injury.Negative pressure is a safe and effective adjunct to delayed soft tissue reconstruction in high-risk patients with severe lower extremity injuries, minimizing reconstructive requirements and therefore postoperative morbidity.

This case presentation focuses on the hemodynamic alterations due to acute clamping of superior vena cava (SVC) during a right pneumonectomy for lung cancer and on the alternatives for drug administration. In a 71-yr-old female patient without clinical manifestations of SVC syndrome, this large vein was clamped for 22 minutes for patch placement after sudden and unpredictable hemorrhage. The patient became acutely cyanotic and edematous in the face and upper extremities, arterial blood pressure dropped and the venous pressure in the right internal jugular vein was elevated. Drugs for managing the patient were given endobronchially and via an established right atrium line. Postoperatively, no neurologic deficit was noted. This case demonstrates the difficulties for managing patients without superior vena cava syndrome in which acute, non-programmed intra-operative SVC clamping is performed, as this is followed by systemic and brain hemodynamic deteriorations that may lead to bad outcome.

We report an uncommon case of pulsatile varicose veins in a young woman caused by tricuspid valve insufficiency of rheumatic origin combined with an incompetent valve at the sapheno–femoral junction. She was treated with limited stripping of the great saphenous vein and local varicosities were excised. Postoperative recovery was complicated by a large haematoma in the thigh. Following our recent experience we believe that patients like this, with elevated venous pressure and requiring anticoagulant therapy for prosthetic valves, should be treated with sapheno–femoral dissociation alone.

A case of a false femoral aneurysm in a young man is reported. The diagnosis was made by MRA and was confirmed by conventional arteriography. MRA was found to be superior to angiography in demonstrating the exact size of the aneurysm. No MRA image of a false aneurysm of the lower extremities has been, to our knowledge, previously reported.

During a 5 year period, 1417 patients with various types of hip fractures were surgically treated. Three cases of iatrogenic arterial injuries occurred during the correction procedures, giving an incidence of 0.21%. In 2 patients the profunda femoral and in one the common femoral artery were involved. The mechanisms of injury were: a protruding screw, beyond the medial border of the femur in the first patient, arterial tear, due to bone speculae in the second and external pressure to the artery from an avulsed lesser trochanter in the third. The clinical findings were false aneurysms in two and distal ischaemia in the third patient. All patients were surgically treated. Early diagnosis of this type of injuries is the cornerstone for a good outcome.

The North Kimberley region survey was undertaken in 1953–54. The area was then amongst the most remote and least known of the continent, requiring complementary work by the Western Australian government that included pack horse reconnaissance for routes for road construction. CSIRO’s contribution included aerial photo interpretation for a preliminary land classification that identified 14 map units, followed by a field survey — largely following new tracks opened by the State Government party. An agricultural economist accompanied the CSIRO landform, soil and vegetation scientists. The area surveyed covered nearly 88,000 km2 of generally rugged terrain extending from sea level to ~855 m dominated by skeletal or sandy soils with eucalyptus woodlands or forests and poor quality pastures. Nine land systems were identified, ranging in area from ~415 km2 to ~41,440 km2 and each with four or five land units. The report describes them in terms of their relative area, topography, soils, vegetation and pastures. General descriptions of location, drainage, geology and geomorphology of the land systems and distribution of the land units with illustrative block diagrams are provided. Individual chapters describe: Climate — general characteristics and their relation to plant growth Geology — stratigraphic units and their relation to land systems Geomorphology — physiography and drainage and characteristics of six geomorphological Soils — major physical and agricultural characteristics of 12 soil groups Vegetation — main features of 76 associations Pastures — composition of 15 types in four groups Present and Potential Land Use – relation to climate and water availability and the carrying capacity of pastures; supplementary chapters discuss economic aspects of the cattle industry and beef production Map 1 — Land Systems of the North Kimberley area, Western Australia by NH Speck. Scale 1:1,000,000. CSIRO Land Research Series No. 4, 1960. Map 2 — Geology of the North Kimberley area, Western Australia by NH Speck. Scale 1:1,000,000. CSIRO Land Research Series No. 4, 1960. Editor's Note: The area has several rivers, notably the Durack, Drysdale, King Edward, Prince Regent, Charnley and Isdell which flow between northeast and west to the strongly indented and often spectacular coast. Tributaries of the Fitzroy River flow south.

CSIRO’s survey of the West Kimberley area covered about 122,000 km2, including the two important coastal towns of Derby and Broome, the inland centre of Fitzroy Crossing and extending east almost to Halls Creek. The survey met a repeated request by the Western Australian government faced with both land degradation and continuing pressure for further developments. Field survey commenced in 1959 and identified 50 land systems ranging from 130 km2 to 15,800 km2 though mostly less than 5,400 km2. The report identifies between two and eight land units in each system and describes the area, landforms, soils and vegetation of 265 land units. The relative positions are shown on block diagrams with general descriptions of the geology and geomorphology of each land system. The report includes chapters describing: Geomorphology — five physiographic divisions divisible into regions in which there is a ‘unity’ in the relief and evolution of the landscape Soil Types — areas that could be considered for irrigation while noting their likely limitations Climate — meteorology and climatic characteristics, and relating climate to plant growth and animal production Vegetation and Pastures — features of upper and lower story plant associations Pasture Lands — additional information on location, area, environment, composition, pastoral value and response to grazing The Pastoral Industry — the beef and sheep industries Agricultural Potential — the potential for rain-fed and irrigated agriculture Map 1 — Lands of the West Kimberley area, Western Australia. Two maps on sheet, each scale 1:1,000,000: Land Systems by RL Wright; Pasture Lands by NH Speck. With insets: Geomorphic Regions and Generalized Geology by RL Wright; Soils by GK Rutherford and Rainfall. CSIRO Land Research Series No. 9, 1964. Editor's Note: As well as ongoing pastoral and pearl industries, the area now has major importance for mining and tourism, and considerable potential for gas, bauxite and other mineral developments.

The Leichhardt–Gilbert survey covered about 300,000 km2 in northwest Queensland. The main settlements included Burketown and Normanton in the northwest, Croydon, Georgetown and Einsleigh in the north and northeast, Hughenden and Richmond in the southeast and Julia Creek and Cloncurry in the south and southwest, but excluding the major mining centre of Mt Isa to the west of the survey area. The survey identified 61 land systems in three physiographic divisions — two upland and an intervening area of broad erosional and alluvial lowland plains with the easterly upland province having some volcanic (lava) plains. Land systems range from 260 km2 to 48,430 km2 although some, mainly stream channels, are very small. The area, landforms, soils and vegetation of 286 land units are described. Individual chapters in the report include: Climate — general characteristics and their relation to plant growth and water requirements for irrigation Geology — relations between geological units and land systems; with notes on economic geology and groundwater Geomorphology — characteristics of three physiographic divisions and six geomorphological units; (Report No. 16 provides a more detailed account of the geology and geomorphology of this survey area) Surface Hydrology — resource availability and issues in dam construction Soils — agricultural characteristics and environmental relationships of 32 soil families Vegetation — plant geography and classification; and the characteristics and distribution of 39 communities Land Use — history, environment and potential for agriculture and grazing; and characteristics of 15 pasture lands in terms of their included land systems, total area, climate and growing season, their main native pasture types, and stocking rates Map 1 — Lands of the Leichhardt–Gilbert area, Queensland, Australia. One sheet: Land Systems by RA Perry. Scale 1:1,000,000. With insets: Geology by CE Prichard; Geomorphic units by CR Twidale; Soils by JR Sleeman; Vegetation by RA Perry. CSIRO Land Research Series No. 11, 1964. The map was digitised by the Queensland Government with permission of CSIRO. Access to the digital file can be obtained from the Queensland Department of Natural Resources and Water Editor's Note: Most of the area is drained northwards to the Gulf of Carpentaria by three major rivers. Smaller areas are drained to the south and inland and east to the Pacific Ocean.

Chronic bilateral ICA occlusion was found in 15 of 3200 patients studied with duplex scanning during a six years period. Ten of these patients had a history of stroke. Mean follow-up was 28.9 months. Six patients died during follow-up, coexisting cardiac ischaemia being the major cause of death. Two patients suffered a stroke (one fatal) resulting in an annual stroke rate of 5.5%, three patients continued to have TIAs and 5 remained asymptomatic. Chronic bilateral ICA occlusion is not always associated with neurological deficit. Coronary ischaemia, more than stroke is the leading cause of death in these patients.

This paper presents a taxonomic revision based on morphology of the genus Eriachne R.Br. which includes 51 taxa (48 species, two varieties and one subspecies), of which 10 species are presented as new. Changes in nurnenclature include three new cornbinations. Five species and 13 varieties are reduced to synonymy, and two trinomials are placed in synonymy. Lectotypes are designated for four taxa. The distributions of E. humilis and E. obtusa are extended to Irian Barat, the former also to Papua New Guinea, and E. armitii and E. nervosa to Western Australia. Cleistogamy and a vesicular indumentum are noteworthy features.

Clausospicula, a new monotypic genus from the Darwin and Gulf District, Northern Territory, Australia, is described and illustrated. Its diagnostic characters include cleistogamous spikelets, reduced panicles, racemes and spikelets, and pedicelled spikelets which are poorly developed and deciduous, or suppressed. Also, the glumes of the bisexual spikelet are awned and slightly keeled or without keels. A prominent feature is the extension of the peduncle into an appendage to which the callus of the bisexual spikelet is attached. The epidermis is notable for its distinct costal and intercostal zones, rectangular intercostal long-cells with tessellated, pitted cell walls, stomata inserted beneath the overlapping interstomatals and arranged in definite rows bordering the costal zones, the presence of macrohairs, narrow microhairs 39–46.5 µm long, silica-celllcork-cell pairs with dumbbell-shaped silica bodies costally and butterfly-shaped silica bodies intercostally. The transverse section shows a distinct midrib with the vascular bundles arranged in a conventional arc abaxially and colourless tissue adaxially, and a symmetrically ordered lamina. The primary vascular bundles are accompanied by sclerenchyma as girders abaxially and adaxially; the adaxial epidermis is extensively bulliform and the abaxial epidermis is of bulliform-like cells.

The indigenous component in Australian sorghums comprises 17 species and 1 variety of which 14 species and the variety are endemic, and 8 taxa are new. Sorghum brevicallosum is reduced to a synonym of S. timorense, which also includes S. australiense. Four previously established, subgenera are accepted with modified circumscriptions and floristic compositions. On morphological evidence, subgenus Stiposorghum represents the most advanced members and subgenus Para-Sorghum the most primitive. Some taxa are polymorphic; others exhibit unique features. Characters relating to pubescence, pruinosity, nervation, lodicules and caryopsis are considered to be unspecialised. First chromosome counts are recorded for eight species. Polyploidy characterises the indigenous species, which comprise diploids, tetraploids, hexaploids and octaploids. Ploidy levels are consistent within the majority of species, but vary in some. The chromosomes of S. macrospermum are markedly smaller than those of any other indigenous species. Cleistogamy occurs in S. laxiflorum. Some species are habitat-specific; many are widely adaptable. With few exceptions, the annual species have restricted distributions. Ecological aspects discussed include seed dormancy and germination, the effects of fire, and patterns of vegetative and floral development phases. Nutritionally, the herbage of both annual and perennial species is deficient in macronutrients, and lacks sufficient N and P to maintain beef cattle. Only the seedheads of S. macrospermum have similar N and P concentrations to those in the grain of the cereal S. bicolor, and in the past they were an important source of starchy food for Aborigines. All the indigenous taxa constitute a genetic resource for potential utilisation by plant breeders.

We investigated the activity of C4 acid decarboxylating enzymes, the PCR (‘photosynthetic carbon reduction’, or ‘Kranz’) bundle sheath anatomy and ultrastructure, and the geographical distribution of Australian species of the C4 grass genus Eragrostis. Species had either the even sheath outline and centripetally located PCR cell chloroplasts characteristic of NAD-malic enzyme (NAD-ME) species (29 spp.), the uneven sheath outline and centrifugal PCR cell chloroplasts characteristic of PEP carboxykinase (PCK) species (28 spp.), or were intermediate between these types (7 spp.). The suberized lamella was present in PCR cell walls of species with PCK-like and intermediate anatomy, and absent from those of species with NAD-ME-like anatomy. Biochemical determination of C4 type for 11 species, however, revealed only NAD-ME activity, irrespective of anatomical type; no PCK activity was detected. PCK-like species arc most numerous in northern, high rainfall, tropical Australia and also predominate in relatively humid coastal and subcoastal areas. NAD-ME-like species are numerically and proportionally dominant where rainfall is < 30 cm year−1. Overall, as many species occur in high as in low rainfall areas. Results are discussed in relation to previously established anatomical/ultrastructural/geographical/biochemical correlations and to Infrageneric taxonomy.

Morphometric analysis of the innervation pattern of the stromal layer of the urinary bladder was done on biopsies from 88 patients with definite multiple sclerosis (MS). The biopsies were stained for acetylcholinesterase and for S100 protein, and a semiquantitative score was assigned. Nearly 30% of the samples showed increased immunoreactivity for S100, indicating Schwann cell hyperplasia. In 16% a decreased S100 immunoreactivity was found, the significance of which is unclear. More than 90% had normal acetylcholinesterase activity. No correlation could be demonstrated for age, sex, severity and duration of the disease, the presence of cystitis and type of detrusor dysfunction. The finding of altered S100 immunoreactivity in MS bladders could indicate that MS also affects the peripheral nervous system and is not limited to the central nervous system as classically described. This finding warrants further investigations.

Vasoactive intestinal polypeptide (VIP)-containing nerves were depleted in the penises of 28 impotent men. The extent of the decrease in VIP-containing nerves broadly reflected the severity of erectile dysfunction. VIP-immunoreactive nerves were most depleted in those men with complete erectile impotence, irrespective of the aetiology of the dysfunction, whereas in those men in whom some erectile function persisted, loss of VIP-immunoreactive nerves was more variable and less complete. Conventional histology demonstrated only mild changes (muscle atrophy and occasional thickening of blood vessel walls). VIP levels, measured by radioimmunoassay of tissue extracts, were depleted by more than 80% in penises from impotent diabetics (43.4 +/- 9.9 pmol/g wet weight [mean +/- SEM]), when compared with 6 controls (189.9 +/- 45.9 pmol/g). These findings not only support the contention that VIP may be the principal neurotransmitter involved in penile erection, but also suggest that depletion of this powerful vasodilatory peptide may play a key role in the development of penile impotence.

Morphometric analysis of the innervation pattern of the stromal layer of the urinary bladder was done on biopsies from 88 patients with definite multiple sclerosis (MS). The biopsies were stained for acetylcholinesterase and for S100 protein, and a semiquantitative score was assigned. Nearly 30% of the samples showed increased immunoreactivity for S100, indicating Schwann cell hyperplasia. In 16% a decreased S100 immunoreactivity was found, the significance of which is unclear. More than 90% had normal acetylcholinesterase activity. No correlation could be demonstrated for age, sex, severity and duration of the disease, the presence of cystitis and type of detrusor dysfunction. The finding of altered S100 immunoreactivity in MS bladders could indicate that MS also affects the peripheral nervous system and is not limited to the central nervous system as classically described. This finding warrants further investigations.

This revision Enneapogon Desv. Ex. P. Beauv. Includes significant taxonomic data on three new taxa (E. decipiens, Kakudidi, E. eremophilus Kakudidi, E. caerulescens var occidentalis Kakudidi) Also, E. truncates Kakudidi is proposed for the species previously known as E. flavescens (Lindl.) N. Burb., as the latter's nomenclatural type belongs to E. nigricans (R. Br.) P. Beauv. New synonyms included E. glaber N. Burb. and E. planiforlius N. Burb. of E. purpurascens (R.Br.) Domin, and E. pallidus var. breviseta N. Burb. of E. lindleyanus (Domin) C.E. Hubb. A previous synonym of E. gracilis (R.Br.) P. Beauv. has been segregated as an independent species (E. virens (Lindl.) Kakudidi). The varietal synonyms, Pappophorum avenaceum var nanum Domin and P. nigricans var barbinode Domin, previously identified as E. polyphyllus and E. polyphyllus nad E. oblongus respectively, are referred to E. avenaceus and E. caerulescens var. caerulescens.

In the previously monotypic genus Whiteochloa, two new species are described and two transferred from Panicum. The original circumscription of the genus is revised to accommodate the five constituent species, which are described in detail and identified by a key.

In the previously monotypic genus Micraira, seven new species are described, all from the Arnhem Land plateau or closely adjoining areas, Northern Territory. All the new species are based on first collections made chiefly in the past 6 years. In distribution the genus is recorded from Western Australia for the first time and the original species (M. subulifolia), previously recorded from Queensland and the Northern Territory, is con- fined to Queensland. A key to the identity of the eight described species is provided. Plants of the genus are considered to have revival properties.

Cyperochloa (type species: C. hirsuta Lazarides & L. Watson), a new monotypic grass genus from Western Australia, is described and illus- trated. It is sedge-like in appearance, with filiform basal leaves and a terminal, solitary, bracteate spike subtended by a spathaceous leaf sheath. Detailed comparisons of its mor- phology and anatomy with 728 generic descriptions in an automated database place it in the Arundinoideae, where it occupies a rather isolated position among the relatives of Danthonia.

A morphological study, based on types and a range of representative material, is presented for 47 species and 1 variety constituting the genus Aristida in Australia as accepted here. Inherent problems of extreme variability and areas of complexity suggest a need for genetic solutions. A. intricata Blake, A. contorta var. hirsuta (Henr.) Eichler, A. ramosa var. scaberula Henr. and A. ramosa var. speciosa Henr. are reduced to synonymy. The following are reported as new or confirmed records: A. exserta Blake in Western ~ustralia; A. calycina R.Br., A. holathera Domin and A. polyclados Domin in Western Australia and Northern Territory; A. latifolia Domin, A, nitidula (Henr.) Blake ex Black and A. jerichoensis (Domin) Henr. var. jerichoensis in New South Wales; A. jerichoensis var. subspinulijera Henr. in South Australia; A. utilis F. M. Bail., A. perniciosa Domin, A. longicollis (Domin) Henr., A, hirta Domin, A. helicophylla Blake, A. superpendens Domin and A. sciuroides Domin in the Northern Territory. Published records of the following require deletion or confirmation: A. jerichoensis and A. gracilipes Henr. in the Northern Territory; A. biglandulosa Black and A. schultzii Mez in Queensland; A. echinata Henr. in Northern Territory and South Australia; A. ingrata Domin, A. longicollis (Domin) Henr, and A. armata Henr. in New South Wales.

Characteristics of gross morphology, epidermal features of the palea of the fertile floret, and leaf anatomy are used to establish a new Australian endemic genus, Yakirra. Its component of five species consists of three transferred from Panicum L. (Yakirra australiensis, Y. pauciflora, Y. majuscula), one from Ichnanthus P. Beauv. '(Y. muelleri) and one new species (Y. nulla Lazarides & R. Webster). A systematic comparison with closely related genera shows the diagnostic features of Yakirra. A morphological key and diagnoses of the species of Yakirra are provided.

A new genus of two species of grasses (Hygrochloa aquatica, H. cravenii), with distinctive aquatic and unisexual features, is described and illustrated. Diagnostic characters include staminate and pistillate, dimorphic spikelets in different parts of the same inflorescence, papillose leaf blades, hollow culms with air canals in the culm walls, and prolonged apices of the rhachides and axes. The genus, though most closely allied to Paspalidium Stapf, is of remote affinity in the Tribe Paniceae.

The opinion is expressed that the genus Ichnanthus Beauv. is represented in Australia by only one species, I. Vicinus (Bail.) Merr. It is proposed to re-establish in Panicum L. three species currently referred to Ichnanthus and transfer to it Ichnanthus muelleri Hughes. A revised account is given of the species concerned as to taxonomy, distribution, and economics.

A taxonomic account is given of the two Australian species of Ottochloa. One of the species, O. nodosa (Kunth) Dandy, has not been recorded previously for Australia as such. The taxa, Ichnanthus oblongus Hughes, unidentified in an earlier paper (Lazarides 1959), and Panicum aequabile Domin, are reduced to synonymy.