Eutrophication of surface water bodies is a worldwide concern. In the USA alone, excessive nutrients are blamed for nearly 5,700 impairments of surface water bodies. Innovative measures, such as ...maximizing drainage ditch nutrient retention, are being examined to decrease the amount of nitrogen (N) and phosphorus (P) running off agricultural lands and into aquatic receiving systems. The goal of this experiment was to measure the nutrient mitigation ability of six aquatic plants typically found in agricultural drainage ditches in the lower Mississippi River Basin. Experimental mesocosms (1.25 × 0.6 × 0.8 m) were filled with sediment and planted with monocultures of one of six obligate wetland plant species (Typha latifolia (broadleaf cattail), Panicum hemitomon (maidencane), Thalia dealbata (powdery alligator-flag), Echinodorus cordifolia (creeping burhead), Myriophyllum spicatum (Eurasian watermilfoil), and Saururus cernuus (lizard's tail)), while three replicates were left non-vegetated to serve as controls. Mesocosms were amended with 5 mg L⁻¹ (each) of nitrate, ammonia, dissolved inorganic phosphorus, and total inorganic phosphorus, while nitrite amendments (1 mg L⁻¹) were also made over a 4-h hydraulic retention time. Following the 4-h exposure, “clean” (non-amended) water was flushed through mesocosms for an additional 8 h to assess residual leaching of nutrients. Outflow water concentrations and loads decreased for all examined forms of N and P. In certain cases, there were significant differences between plant species; however, for the majority, there was no statistical difference in percent decrease between plant species. While native aquatic vegetation shows promise for mitigation of nutrient runoff, further studies altering the hydraulic retention time for improved efficiency should be conducted.
By the year 2050, the population of the United States is expected to reach over 418 million, while the global population will reach 9.6 billion. To provide safe food and fiber, agriculture must ...balance pesticide usage against impacts on natural resources. Challenges arise when storms cause runoff to be transported to aquatic receiving systems. Vegetated systems such as drainage ditches and constructed wetlands have been proposed as management practices to alleviate pesticide runoff. Twelve experimental mesocosms （1.3 ±0.71 ± 0.61 m） were filled with sediment and planted with a monoculture of one of three wetland plant species （Typha latifolia, Leersia oryzoides, and Sparganium arnericanurn）. Three mesocosms remained unvegetated to serve as controls. All mesocosms were amended with 9.2 ± 0.8 μg/L, 12 ± 0.4 μg/L, and 3.1 ± 0.2 μg/L of atrazine, metolachlor, and diazinon, respectively, over a 4 hr hydraulic retention time to simulate storm runoff. Following the 4 hr amendment, non-amended water was flushed through mesocosms for an additional 4 hr. Outflow water samples were taken hourly from pre-amendment through 8 hr, and again at 12, 24, 48, 72, and 168 hr post-amendment. L. oryzoides and T. latifolia had mean atrazine, metolachlor, and diazinon retentions from B1%-55% for the first 4 hr of the experiment. Aside from S. arnericanum and atrazine （25% retention）, unvegetated controls had the lowest pesticide retention （17%-28%） of all compared mesocosms. While native aquatic vegetation shows promise for mitigation of pesticide runoff, further studies increasing the hydraulic retention time for improved efficiency should be examined.
Large tracts of lowlands have been drained to expand extensive agriculture into areas that were historically categorized as wasteland. This expansion in agriculture necessarily coincided with changes ...in ecosystem structure, biodiversity, and nutrient cycling. These changes have impacted not only the landscapes in which they occurred, but also larger water bodies receiving runoff from drained land. New approaches must append current efforts toward land conservation and restoration, as the continuing impacts to receiving waters is an issue of major environmental concern. One of these approaches is agricultural drainage management. This article reviews how this approach differs from traditional conservation efforts, the specific practices of drainage management and the current state of knowledge on the ecology of drainage ditches. A bottom-up approach is utilized, examining the effects of stochastic hydrology and anthropogenic disturbance on primary production and diversity of primary producers, with special regard given to how management can affect establishment of macrophytes and how macrophytes in agricultural landscapes alter their environment in ways that can serve to mitigate non-point source pollution and promote biodiversity in receiving waters.
Abstract
Purpose
Lymphoceles often occur within several weeks or even months after surgery. Mostly asymptomatic and therefore undiagnosed, they may be self-healing without any treatment. A small ...percentage of postoperative lymphoceles are symptomatic with significant pain, infection, or compression of vital structures, thus requiring intervention. Many different treatment options are described in the literature, like drainage with or without sclerotherapy, embolization of lymph vessels, and surgical approaches with laparoscopy or laparotomy. Inspired by reports stating that postoperative suction drainage can prevent the formation of lymphoceles, we developed a simple protocol for vacuum-assisted drainage of symptomatic lymphoceles, which proved to be successful and which we would therefore like to present.
Materials and Method
Between 2008 and 2020, 35 patients with symptomatic postoperative lymphoceles were treated with vacuum-assisted suction drainage (in total 39 lymphoceles). The surgery that caused lymphocele formation had been performed between 8 and 572 days before. All lymphoceles were diagnosed based on biochemical and cytologic findings in aspirated fluid. The clinical and imaging data were collected and retrospectively analyzed.
Results
In total, 43 suction drainage catheters were inserted under CT guidance. The technical success rate was 100 %. One patient died of severe preexisting pulmonary embolism, sepsis, and poor conditions (non-procedure-related death). In 94.8 % of symptomatic lymphoceles, healing and total disappearance could be achieved. 4 lymphoceles had a relapse or dislocation of the drainage catheter and needed a second drainage procedure. Two lymphoceles needed further surgery. The complication rate of the procedure was 4.6 % (2/43, minor complications). The median indwelling time of a suction drainage catheter was 8–9 days (range: 1–30 days).
Conclusion
The positive effects of negative pressure therapy in local wound therapy have been investigated for a long time. These positive effects also seem to have an impact on suction drainage of symptomatic lymphoceles with a high cure rate.
Key Points:
Suction drainage of lymphoceles is an easy and successful method to cure symptomatic lymphoceles at various locations.
We believe this to be due to the induction of cavity collapse and surface adherence.
In most cases rapid clinical improvement could be obtained.
Citation Format
Franke M, Saager C, Kröger J et al. Vacuum-Assisted Suction Drainage as a Successful Treatment Option for Postoperative Symptomatic Lymphoceles. Fortschr Röntgenstr 2022; 194: 384 – 390
Excess nutrient loading from agricultural landscapes contributes to downstream water quality degradation. To mitigate these issues, agricultural drainage ditches have recently gained attention as ...potential sites for nutrient reduction. We examined the effects of vegetation and hydrology on oxidation-reduction (redox) potential. Testing occurred in an agricultural drainage ditch fitted with weirs in the summer of 2012. Redox potential was recorded using continuous automated data loggers and analyzed using both frequentist and Bayesian methods. Significant difference was found when analyzing redox potential response to vegetation (
t
= −1.75,
P
= 0.08, df = 9754) and hydrology treatments (
t
= 7.51,
P
< 0.001, df = 9754) in a frequentist manner. Vegetation and hydrologic treatments were significant when analyzed using Bayesian methods; however, the interactions of the two terms had the greatest posterior weights. This study suggests that the innovative use of vegetation and controlled drainage can affect Eh, in particular Eh heterogeneity within ditch systems. Results obtained by analyzing these data in both a frequentist and Bayesian methods were similar in terms significance and magnitude. However, Bayesian methods, and their ability to incorporate prior information into a management framework, may be better suited for systems where previous information can be incorporated into analyses.
Cerebrospinal fluid (CSF) dynamics in the cervical spinal subarachnoid space (SSS) have been thought to be important to help diagnose and assess craniospinal disorders such as Chiari I malformation ...(CM). In this study we obtained time-resolved three directional velocity encoded phase-contrast MRI (4D PC MRI) in three healthy volunteers and four CM patients and compared the 4D PC MRI measurements to subject-specific 3D computational fluid dynamics (CFD) simulations. The CFD simulations considered the geometry to be rigid-walled and did not include small anatomical structures such as nerve roots, denticulate ligaments and arachnoid trabeculae. Results were compared at nine axial planes along the cervical SSS in terms of peak CSF velocities in both the cranial and caudal direction and visual interpretation of thru-plane velocity profiles. 4D PC MRI peak CSF velocities were consistently greater than the CFD peak velocities and these differences were more pronounced in CM patients than in healthy subjects. In the upper cervical SSS of CM patients the 4D PC MRI quantified stronger fluid jets than the CFD. Visual interpretation of the 4D PC MRI thru-plane velocity profiles showed greater pulsatile movement of CSF in the anterior SSS in comparison to the posterior and reduction in local CSF velocities near nerve roots. CFD velocity profiles were relatively uniform around the spinal cord for all subjects. This study represents the first comparison of 4D PC MRI measurements to CFD of CSF flow in the cervical SSS. The results highlight the utility of 4D PC MRI for evaluation of complex CSF dynamics and the need for improvement of CFD methodology. Future studies are needed to investigate whether integration of fine anatomical structures and gross motion of the brain and/or spinal cord into the computational model will lead to a better agreement between the two techniques.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is an established treatment option for patients with hepatocellular carcinoma (HCC). However, optimising treatment ...application and patient selection remains challenging. We report here on the effectiveness, safety and prognostic factors, including dosing methods, associated with TARE for HCC in the prospective observational CIRT study.
We analysed 422 patients with HCC enrolled between Jan 2015 and Dec 2017, with follow-up visits every 3 months for up to 24 months after first TARE. Patient characteristics and treatment-related data were collected at baseline; adverse events and time-to-event data (overall survival OS, progression-free survival PFS and hepatic PFS) were collected at every 3-month follow-up visit. We used the multivariable Cox proportional hazard model and propensity score matching to identify independent prognostic factors for effectiveness outcomes.
The median OS was 16.5 months, the median PFS was 6.1 months, and the median hepatic PFS was 6.7 months. Partition model dosimetry resulted in improved OS compared to body surface area calculations on multivariable analysis (hazard ratio 0.65; 95% CI 0.46-0.92; p = 0.0144), which was confirmed in the exact matching propensity score analysis (hazard ratio 0.56; 95% CI 0.35-0.89; p = 0.0136). Other independent prognostic factors for OS were ECOG-performance status >0 (p = 0.0018), presence of ascites (p = 0.0152), right-sided tumours (p = 0.0002), the presence of portal vein thrombosis (p = 0.0378) and main portal vein thrombosis (p = 0.0028), ALBI grade 2 (p = 0.0043) and 3 (p = 0.0014). Adverse events were recorded in 36.7% of patients, with 9.7% of patients experiencing grade 3 or higher adverse events.
This large prospective observational dataset shows that TARE is an effective and safe treatment in patients with HCC. Using partition model dosimetry was associated with a significant improvement in survival outcomes.
Transarterial radioembolization (TARE) is a form of localised radiation therapy and is a potential treatment option for primary liver cancer. We observed how TARE was used in real-life clinical practice in various European countries and if any factors predict how well the treatment performs. We found that when a more complex but personalised method to calculate the applied radiation activity was used, the patient responded better than when a more generic method was used. Furthermore, we identified that general patient health, ascites and liver function can predict outcomes after TARE.
NCT02305459.
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•CIRT is a large, European-wide multicentre prospective observational study.•Partition model dosimetry is associated with improved overall survival compared to the standard body surface area model.•ALBI grades, ECOG status, ascites, portal vein thrombosis and tumour location predict survival outcomes after TARE.•TARE is a safe treatment associated with a low occurence of adverse events.
To evaluate the usefulness of spectral detector CT (SDCT)-derived pulmonary perfusion maps and pulmonary parenchyma characteristics for the semiautomated classification of pulmonary hypertension ...(PH).
A total of 162 consecutive patients with right heart catheter (RHC)-proven PH of different aetiologies as defined by the current ESC/ERS guidelines who underwent CT pulmonary angiography (CTPA) on SDCT and 20 patients with an invasive rule-out of PH were included in this retrospective study. Semiautomatic lung segmentation into normal and malperfused areas based on iodine density (ID) as well as automatic, virtual non-contrast-based emphysema quantification were performed. Corresponding volumes, histogram features and the ID Skewness
-Emphysema-Index (δ-index) accounting for the ratio of ID distribution in malperfused lung areas and the proportion of emphysematous lung parenchyma were computed and compared between groups.
Patients with PH showed a significantly greater extent of malperfused lung areas as well as stronger and more homogenous perfusion defects. In group 3 and 4 patients, ID skewness revealed a significantly more homogenous ID distribution in perfusion defects than in all other subgroups. The δ-index allowed for further subclassification of subgroups 3 and 4 (
< 0.001), identifying patients with chronic thromboembolic PH (CTEPH, subgroup 4) with high accuracy (AUC: 0.92, 95%-CI, 0.85-0.99).
Abnormal pulmonary perfusion in PH can be detected and quantified by semiautomated SDCT-based pulmonary perfusion maps. ID skewness in malperfused lung areas, and the δ-index allow for a classification of PH subgroups, identifying groups 3 and 4 patients with high accuracy, independent of reader expertise.
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