Trialling water treatment residuals in the remediation of former mine site soils: investigating improvements achieved for plants, earthworms and soil solution.

During clarification processes of raw water a vast amount of by-product known as drinking water treatment residuals (WTRs) are produced, being principally composed of hydroxides of the Al or Fe salts added during water treatment plus the impurities they remove. Aluminium-based (Al-WTR) and iron-based (Fe-WTR) materials were applied at 10% w/w to degraded, bare (un-vegetated) soils from a restored coal mining site in central England (pH <3.9) to study their potential amelioration effects on earthworm mortality, biomass yield of seedling plants and element concentrations in plant tissues, earthworm tissues and in soil solutions. A separate treatment with agricultural lime was also conducted for comparison to evaluate whether any observed improvements were attributable to the liming capacity of the WTRs. After completion of the trials all samples were subjected to a wet-dry cycle and the experiments were repeated (i.e. simulating longer-term effects in the field). Both types of WTRs significantly increased biomass of plants and, in some treatments, survival of earthworms was also enhanced compared to non-amended soils. Excess plant tissue element concentrations and element concentrations in soil solutions were reduced in amended soils. The implications are that adding WTRs to mining impacted soils is a potentially viable, sustainable and low cost remediation method that could be used globally to improve the soil condition. This article is protected by copyright. All rights reserved

ЛЕЧЕНИЕ ПАЦИЕНТОВ С НАРУЖНЫМИ ПАНКРЕАТИЧЕСКИМИ СВИЩАМИ ПОСЛЕ ЧРЕСКОЖНЫХ ДРЕНИРУЮЩИХ ОПЕРАЦИЙ ПСЕВДОКИСТ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫ

Introduction. External pancreatic fistulas are developed up to 45 % during the postoperative period after the percutaneous drainage of pancreatic pseudocysts. According to some authors this fact is the main contraindication for using of transcutaneous method in  treatment of these patients.The objective is to optimize the tactics of treatment for minimizing the possible development of external pancreatic fistulasMaterials and methods. Puncture-draining operations were performed in 164 patients with chronic pancreatic pseudocysts. Puncture operations with ultrasound control were primarily performed in 54 patients (32.9 %), they were effective for 29 patients (53.7 %). Traditional surgical interventions were performed in 7 patients (12.9 %) from this group. Percutaneous drainage of pseudocyst was secondary used in 18 patients (33.4 %). Percutaneous drainage of pseudocysts was primarily used in other group consisting of 110 (67.1 %) patients. During the postoperative period, external pancreatic fistula formed in 36 (32.7 %) patients from this group. The fistulas were eliminated by supplementing the transcutaneous interventions with endoscopic methods.Results. Endoscopic papillosphincterotomy was performed in 36 patients. Pancreatic fistulas were closed after the operation in 12 patients (33.3 %). Endoscopic formation cystogastro-, cystoduodenoanastomosis on «lost drainage» were performed in 9 patients (25 %). Temporary decompression transpapillary stenting of the MPD was performed in 15 patients (41.7 %), endoscopic retrograde stenting was performed in 5 of them. Antegrade stenting of the MPD was transcutaneously performed in 10 patients. There were no lethal outcomes. Fistulas regressed in all patients. Recurrence of cyst formation, pancreatic hypertension were not be to dynamic examinations. Algorithm of treatment was formed and based on the results of a retrospective analysis to treatment of pancreatic cysts in general surgical clinic of «Pavlov First Saint Petersburg State Medical University».Conclusions. Coherent combining of minimally invasive technologies in the treatment of patients with chronic pancreatic pseudocysts leads to good results: absolute cystic regression and elimination of pancreatic fistulas as appropriate.Введение. После проведенного чрескожного дренирования псевдокист поджелудочной железы до 45 % случаев в послеоперационном периоде развиваются наружные панкреатические свищи, что является основным противопоказанием к применению транскутанного метода, по мнению ряда авторов, в лечении данной категории больных.Цель – оптимизировать тактику лечения с целью минимизации возможного риска развития наружных панкреатических свищей.Материал и методы. 164 пациентам с хроническими псевдокистами поджелудочной железы проводились пункционно-дренирующие операции. 54 пациентам (32,9 %) первично выполнялись пункционные операции под УЗ-контролем, с положительным эффектом – у 29 больных (53,7 %). 7 пациентам (12,9 %) из этой группы выполнены традиционные оперативные вмешательства. 18 пациентам (33,4 %) выполнены вторично чрескожные дренирования полостей псевдокист. Другой группе, состоявшей из 110 (67,1 %) пациентов, выполнено первично чрескожное дренирование псевдокист. В послеоперационном периоде у 36 (32,7 %) пациентов из этой группы в течение месяца сохранялось панкреатическое отделяемое с формированием наружного панкреатического свища. Ликвидация свищей производилась за счет дополнения транскутанных вмешательств эндоскопическими методами.Результаты исследования. 36 пациентам выполнялась эндоскопическая папиллосфинктеротомия. У 12 (33,3 %) после проведенной операции панкреатические свищи закрылись. 9 (25 %) пациентам эндоскопически сформированы цистогастро-, цистодуоденоанастомозы на «потерянном дренаже». 15 (41,7 %) пациентам было выполнено временное декомпрессионное транспапиллярное стентирование ГПП, из которых 5 больным выполнено эндоскопическое ретроградное стентирование. 10 пациентам стентирование ГПП произведено антеградным методом транскутанно. Летальных исходов не наблюдалось. У всех пациентов свищи регрессировали. При динамическом обследовании рецидива кистообразования, панкреатической гипертензии не наблюдалось. По результатам ретроспективного анализа материалов, полученных в ходе лечения больных панкреатическими кистами на базе клиники общей хирургии ПСПбГМУ им. И. П. Павлова, сформирован алгоритм лечения.Выводы. Последовательное комбинирования использование миниинвазивных технологий в лечении пациентов с хроническими псевдокистами поджелудочной железы позволяет добиться хороших результатов: абсолютного кистозного регресса, при необходимости, ликвидации панкреатических свищей

TREATMENT OF COMPLICATIONS AFTER PERCUTANEOUS ENDOBILIARY INTERVENTIONS FOR OBSTRUCTIVE JAUNDICE

OBJECTIVE. The aim of the study is to improve the results of treatment in patients with complications after percutaneous endobiliary operations for obstructive jaundice. MATERIAL AND METHODS. The percutaneous endobiliary interventions for obstructive jaundice were performed in 208 patients. Intraoperative and early postoperative complications were diagnosed in 38 patient (18.2 %). operative and endovideosurgical interventions were used in the treatment of complications. RESULTS. hemorrhagic complications were 4.3 % of cases. Bile outflow in the postoperative period were observed in 14 patients (6.7 %). Infection complication were identified in 15 patients (7.2 %). The treatment of complications with minimally invasive methods was successful in all cases. CONCLUSION. In most cases, the complications of percutaneous endobiliary operations can be resolved minimally invasive ways

TREATMENT OF PATIENTS WITH EXTERNAL PANCREATIC FISTULAS AFTER PERCUTANEOUS DRAINAGE INTERVENTIONS OF PANCREATIC PSEUDOCYSTS

Introduction. External pancreatic fistulas are developed up to 45 % during the postoperative period after the percutaneous drainage of pancreatic pseudocysts. According to some authors this fact is the main contraindication for using of transcutaneous method in  treatment of these patients.The objective is to optimize the tactics of treatment for minimizing the possible development of external pancreatic fistulasMaterials and methods. Puncture-draining operations were performed in 164 patients with chronic pancreatic pseudocysts. Puncture operations with ultrasound control were primarily performed in 54 patients (32.9 %), they were effective for 29 patients (53.7 %). Traditional surgical interventions were performed in 7 patients (12.9 %) from this group. Percutaneous drainage of pseudocyst was secondary used in 18 patients (33.4 %). Percutaneous drainage of pseudocysts was primarily used in other group consisting of 110 (67.1 %) patients. During the postoperative period, external pancreatic fistula formed in 36 (32.7 %) patients from this group. The fistulas were eliminated by supplementing the transcutaneous interventions with endoscopic methods.Results. Endoscopic papillosphincterotomy was performed in 36 patients. Pancreatic fistulas were closed after the operation in 12 patients (33.3 %). Endoscopic formation cystogastro-, cystoduodenoanastomosis on «lost drainage» were performed in 9 patients (25 %). Temporary decompression transpapillary stenting of the MPD was performed in 15 patients (41.7 %), endoscopic retrograde stenting was performed in 5 of them. Antegrade stenting of the MPD was transcutaneously performed in 10 patients. There were no lethal outcomes. Fistulas regressed in all patients. Recurrence of cyst formation, pancreatic hypertension were not be to dynamic examinations. Algorithm of treatment was formed and based on the results of a retrospective analysis to treatment of pancreatic cysts in general surgical clinic of «Pavlov First Saint Petersburg State Medical University».Conclusions. Coherent combining of minimally invasive technologies in the treatment of patients with chronic pancreatic pseudocysts leads to good results: absolute cystic regression and elimination of pancreatic fistulas as appropriate