​ConsultantConsultant cardiothoracic surgeon Blackpool (b 1960; q Liverpool 1984; FRCS, MD), died from a brain tumour on 25 October 2003. Dave was an enthusiastic teacher. As a consultant he had just spent his first two years settling into his post and bringing many of his initial ideas to fruition. Dave had two major passions in life—his family and cardiac surgery—and, despite the often conflicting demands of these commitments, he dedicated himself to both with gusto and excellence. He leaves a wife, Lorna, and two children. Figure 1

Objective: Vancomycin is effective in reducing the risk of mediastinits and topical vancomycin has been hypothesised to give high local dose concentrations while avoiding high systemic levels, thus avoiding the risk of bacterial resistance to this second-line antibiotic. However, this theory has never been tested and the degree to which vancomycin is absorbed systemically is unknown. Methods: Fourteen patients undergoing elective coronary artery bypass grafts (CABG) received 500 mg of topical vancomycin prior to stemotomy closure. Serum samples were taken at 30, 60, 120, 180 and 720 min post-operatively. In addition, samples were taken from the drain bottles and urine samples taken daily for 5 days. Vancomycin levels were measured by fluorescence polarisation immunoassay, using the reverse dilution method to give a detection limit of 0.8 mg/l. Results: Vancomycin was detected in almost all serum samples. Peak concentration was at 30 min and the mean value was 2.96 mg/l (range, 0.99-5.00 mg/l). This mean fell to 1.32 mg/l at 6 h. Of the 500 mg of vancomycin applied, a mean of only 8.8 mg was found to have been lost into the drain bottles in the first 24 h (range, 0.17-12.5 mg). When 5 consecutive days of urine collection was achieved, a mean of 151 mg of vancomycin was excreted (range, 40-195 mg) and vancomycin was detectable in the urine till day 5. The mean concentration of vancomycin in the urine was maximal on day 1 and was 24.4 mg/l (range, 4.49-44.98 mg/l). Conclusions: Topical vancomycin causes significant systemic concentrations in the 6 h post-surgery and can be detected in the urine for up to 5 days post-surgery. (C) 2003 Elsevier Science B.V. All rights reserved.

In this part, a new hybrid numerical model for solving the two-dimensional axisymmetric Navier-Stokes equations for a multi-species reacting gas out of thermal and chemical equilibrium is constructed. The formulation is based on a mixed finite volume/finite element formulation for unstructured meshes. The convective flux is treated with an approximate Osher-Riemann solver, and the other fluxes are treated using P1 finite elements. New aspects of the extension of the Osher-Riemann solver are presented here. This scheme was used for the benchmark model comparison in Part I, and is applied here to hypersonic (Mach 25) flow past a two-dimensional ellipse and a hemispherically blunted body at sea level. Copyright (C) 2000 John Wiley & Sons, Ltd.

A theoretical model for high speed flow of chemically reacting gases out of thermal and chemical equilibrium is presented. The main features of the physical model are discussed together with details for a new form of the kinetic rate coefficients for non-equilibrium flows and presentation of a two-layer radiation model used for a plasma torch problem. This model is implemented in a new hybrid finite volume/finite element scheme, which is developed in Part 2. Results from this physical model are compared with experiments and other results in the literature for an arcjet and non-equilibrium nozzle test case. Sensitivity studies are included for the nozzle problem to simulate the influence of the rate coefficients

This study concerns the application of a class of `time-iterative' methods to several different classes of problems in fluid mechanics. These new iterative methods combine ideas from multi-stage Runge–Kutta (RK) integration together with a selection of Chebyshev iteration parameters. The underlying performance of these Chebyshev parameterized Runge–Kutta (CPRK) solvers is studied for steady-state solution to a representative sampling from: (i) transport involving convection and diffusion; (ii) incompressible viscous flow governed by the Navier–Stokes equations; (iii) supercritical flume flow in shallow-water theory and (iv) compressible, viscous hypersonic gas flow with multiple reacting species. We provide numerical results to demonstrate convergence to the steady-state flow in each case and give graphs showing residual decay for the CPRK and standard RK schemes.

In this study we describe parallel iterative and direct solution strategies for viscous flow computation using domain decomposition. Both stream function vorticity and primitive variable formulations are considered. The basic ideas associated with the element-by-element approach and subdomain approach can also be extended to other cell or control-volume approximate formulations. Numerical results and parallel performance studies are presented for computations with parallel sparse solution based on p − multilevel schemes and multiple front elimination schemes.