and the mean (range) size was 11.9 (2.9-24.4) cm. All patients were treated by selective embolization using a mixture of alcohol and lipiodol. Three patients also had coiling of aneurysms and two patients had additional embolization with polyvinyl alcohol particles. The follow-up was both radiological and clinical, with recurrence defined as growth by > 2 cm or symptoms requiring further treatment. RESULTSThe technical success rate was 100%, with only one significant complication of nontarget renal embolization, with self-limiting effects. Minor complications included 11 patients with post-embolization syndrome, all of which settled with conservative measures. The mean (range) combined radiological and clinical follow-up was 44.2 (12-116) months, with all patients having a follow-up of > 1 year. Radiological success was achieved in 97%, with only one lesion growing by > 2 cm. The combined clinical and radiological success rate was 85%, with two patients undergoing surgery, two having repeat embolization and one currently offered surgery due to a recent increase in size. CONCLUSIONOur study provides long-term evidence that selective arterial embolization with alcohol is a safe and effective method for improving clinical symptoms (85%) and preventing tumour progression (97%) in patients with renal angiomyolipoma.

IntroductionInfra-popliteal angioplasty continues to be widely performed with minimal evidence to guide practice. Endovascular device selection is contentious and there is even uncertainty over which artery to treat for optimum reperfusion. Direct reperfusion (DR) targets the artery supplying the ischaemic tissue. Indirect reperfusion (IR) targets an artery supplying collaterals to the ischaemic area. Our unit practice for the last eight years has been to attempt to open all tibial arteries at the time of angioplasty. When successful, this results in both direct and indirect; or combined reperfusion (CR). The aim was to review the outcomes of CR and compare them with DR or IR alone.MethodsAn eight year retrospective review from a single unit of all infra-popliteal angioplasties was undertaken. Wound healing, limb salvage, amputation-free and overall survival data as well as re-intervention rates were captured for all patients. Subgroup analysis for diabetics was undertaken. Kaplan Meier curves are presented for survival outcomes. All odds and hazard ratios (HR) and p values were corrected for bias from confounders using multivariate analysis.Results250 procedures were performed: 22 (9%) were CR; 115 (46%) DR and 113 (45%) IR. Amputation-free survival (HR 0.504, p = 0.039) and re-intervention and amputation-free survival (HR 0.414, p = 0.005) were significantly improved in patients undergoing CR compared to IR. Wound healing was similarly affected by reperfusion strategy (OR = 0.35, p = 0.047). Effects of CR over IR were similar when only diabetic patients were considered.ConclusionsCombined revascularisation can only be achieved in approximately 10% of patients. However, when successful, it results in significant improvements in wound healing and amputation-free survival over simple indirect reperfusion techniques.

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Earlier studies have shown the significant impact of leaf glaucousness and cooler canopies on wheat (Triticum aestivum L.) yield. However, breeding for drought adaptive traits and potential yield as responses to heat or water deficit were poor. The genetic basis for drought-adaptive traits and yield potential were assessed using quantitative trait locus (QTL) analysis. The 180 recombinant inbred lines (RILs) were derived from a cross between 'Len' (USA) and 'Halberd' (Australian) wheat lines. The RIL population and the parents were genotyped with a 90K Infinium single nucleotide polymorphism (SNP) library to construct 22 linkage groups. The QTLs segregating for leaf epicuticular wax (EW), cooler canopies, drought susceptibility index (DSI), and grain attributes were identified in the population across five environments. The QTLs associated with leaf EW, cooler canopies, DSI-mean single head weight (MSHW), DSI-thousand-kernel weight (TKW), and grain attributes co-localized on chromosomes 1A, 2B, 3B, 6B, 7A, and 7B. Gene ontology of the leaf EW QTLs on chromosomes 2B and 3B indicated that their sequences were similar to an Arabidopsis ABC transporter gene, and the leaf EW QTL on chromosome 7B was similar to the sorghum [Sorghum bicolor (L.) Moench] ethylene-insensitive gene. The favorable alleles associated with moisture stress tolerance were associated with the Halberd parent. The genetic loci (QWax.tam-3B and QCTP.tam-2B, QDSIM.tam-2B.1) with higher logarithm of odds (LOD) and Rš values could be important potential tools in breeding to improve. The chromosomal regions identified in this study can provide breeders with additional tools to develop drought-and heat-tolerant cultivars through breeding.