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김창균,William Paul Clarke,David Lockington 한국지하수토양환경학회 1999 지하수토양환경 Vol.4 No.2
The unknown amount of thiolane retained on different soil matrix was characterized by employing an uniquely designed glass vessel, which was forced to purge the prepared slurry sample so that thiolane may diffuse into Tenax/charcoal tube. Thiolane can be recovered ranging from approximately 89% at 1 ppm regardless of soil types, which was not consequently affected by potential biodegradation during sample preparation. For 5ppm, thiolane is more recoverable up to 92% for sand, whereas it was poorly recovered as low as 85% for clay. It strongly suggests that controls should be considered when soil types varied in a concerned area. The technique was eventually capable of determination of thiolane for the samples taken from the site which led to be taken into consideration for proper site remediation.
David A. Clark,Bree Stephensen,Aleksandra Edmundson,Daniel Steffens,Michael Solomon 대한대장항문학회 2021 Annals of Coloproctolgy Vol.37 No.5
Purpose: Anastomotic leak (AL) after a low pelvic anastomosis is a devastating complication, with short- and long-term morbidity and increased mortality. Surgeons may employ various adjuncts in an attempt to reduce AL rates or mitigate their impact. These include the use of temporary diverting ileostomy (TDI), transanal or rectal tubes and pelvic drains. This questionnaire evaluates the preferences and routine use of these adjuncts in Australasian colorectal surgeons.Methods: A cross-sectional survey was administered to Australian and New Zealand colorectal surgeons on September 20, 2018. The study survey consisted of 15 questions exploring basic demographics and the number of rectal resections and ileal pouches performed in 12 months, along with the surgeon’s preference for the use of diverting stomas, rectal tubes, and pelvic drains.Results: There were 90 respondents to the survey (31.6%). Surgeons in Western Australia (71.4%) were more likely to use a mandatory TDI in colorectal extraperitoneal anastomoses than surgeons in Queensland (14.3%). South Australian surgeons are more likely to employ a mandatory TDI (100%) for ileal pouches than Queensland surgeons (42.9%). Rectal tubes are not commonly utilized (40.0% never use them), and pelvic drains are (45.6% in all cases). Surgeons consider a median AL rate of 15% was felt to justify the use of a TDI in low pelvic anastomoses and a median AL rate of 10% for ileal pouchesConclusion: There is considerable geographical variation in colorectal surgical practice throughout Australia and New Zealand. While surgeons interrogate the same literature, there are presumably other factors that see translation into variations in clinical practice.
A development study of drain fluid gastrografin as a biomarker of anastomotic leak
David A. Clark,Edward Yeoh,Aleksandra Edmundson,Craig Harris,Andrew Stevenson,Daniel Steffens,Michael Solomon 대한대장항문학회 2022 Annals of Coloproctolgy Vol.38 No.2
Purpose: Anastomotic leakage (AL) is the anathema of colorectal surgery. Its occurrence leads to increased morbidity and mortality and a prolonged hospital stay. Much work has gone into studying various biomarkers in drain fluid to facilitate early detection of AL. This stage 2a development study aims to assess the safety and feasibility of reliably detecting the iodine in Gastrografin (GG; Bayer Australia Ltd.) in drain fluid and stool samples by dual-energy computed tomography (DECT). Methods: This is a prospective, observational, controlled, consecutive cohort study establishing the safety and feasibility of the detection of GG in surgical drain fluid and stool as a biomarker of AL when patients with a low pelvic colorectal anastomosis undergo luminal flushing of the rectal tube with GG. Results: Ten consecutive patients were allocated to the saline flush group and the following 10 to the GG flush group. Three patients in the saline flush group developed an AL. One patient in the GG flush group developed an AL. An elevation in the drain fluid GG was detected using DECT on the day of clinical deterioration. None of the patients in the control group were found to have a positive result on DECT. Conclusion: This study demonstrates the safety of a novel approach to the early detection of AL from extraperitoneal colorectal anastomoses. The technique requires validation in a larger cohort and a multicenter study is planned to investigate the efficacy of GG rectal tube flushes as an early biomarker of AL in low pelvic anastomoses.