Comparison of perventricular and percutaneous ultrasound-guided device closure of perimembranous ventricular septal defects.

Background: Ultrasound-guided percutaneous device closure of perimembranous ventricular septal defects (PmVSD) is a minimally invasive recent treatment approach. Perventricular PmVSD device closure is an emerging radiation-free intervention, yet it comes with certain limitations. No studies compared both of these treatment approaches. Methods: We performed a retrospective institutional data comparison of percutaneous (PCP Group, n = 138) and perventricular (PVP Group, n = 67) ultrasound-guided device closure procedures in 205 patients with PmVSD between March 2017 and December 2022. Results: Patients of the PCP and PVP groups had a median age of 4.9 years (IQR, 3.1-14.0) and 5.3 years (IQR, 3.4-13.1) respectively. The median PmVSD diameter in the PCP Group was 4.0 mm (IQR, 3.3-5.3) and 5.2 mm (IQR, 4.0-7.0) in the PVP Group (p = 0.001). There was no significant difference in success rates between the PCP and PVP Groups (intention-to-treat population, 88.4% vs. 92.5%, p = 0.36; as-treated population, 88.4% vs. 89.3%, p = 0.84). 5/8 failed percutaneous cases that were shifted to the perventricular approach were successful. Compared to the PVP Group, patients of the PCP group experienced a significant decrease in ventilation time, drainage volume, and postoperative hospital stay (p < 0.001). The median follow-up period was 24 months (IQR, 6-42) for the PCP group and 61 months (IQR, 53-65) for the PVP group. The overall severe adverse event rate was 0% in the PCP group and 3.0% in the PVP group. Conclusions: Perventricular and percutaneous ultrasound-guided device closure of PmVSD are both effective and safe treatment options. The percutaneous approach offers less trauma and faster recovery and may be the preferred approach in selected patients.

Distribution of PCDD/Fs and organometallic compounds in sewage sludge of wastewater treatment plants in China.

Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), organotin and organolead compounds were measured in sewage sludge samples collected from 24 wastewater treatment plants from 18 cities of 13 provinces in China. Total international toxicity equivalent (I-TEQ) values were evaluated for PCDD/Fs. The total concentration of PCDD/Fs ranged from 104.0 to 1661 pg/g dry weight (d.w.) and 2.51-75.21 pg I-TEQ/g d.w., indicating that all I-TEQs were below Chinese legislation limit value regulated for land application. The concentrations ranged from 258 to 3886, 126 to 1129, and 84-2133 ng/g as Sn d.w., for tributyltin (TBT), dibutyltin (DBT), and diphenyltin (DPhT), respectively. On the other side, organolead concentrations ranged from 85 to 668 with an average of 279 ng/g as lead. High concentrations of organolead compounds in sewage sludge indicated that the environmental impact of organolead compounds remains in China.

Distribution and characterization of organochlorine pesticides and polycyclic aromatic hydrocarbons in surface sediment from Poyang Lake, China.

The concentrations of organochlorine pesticides (OCPs) and 16 priority polycyclic aromatic hydrocarbons (PAHs) were investigated in the sediments from Poyang Lake, the largest freshwater lake in China. The results showed that the total concentrations of four hexachlorocyclohexane (HCH) isomers (α-HCH, ß-HCH, γ-HCH, δ-HCH), three dichlorodiphenyltrichloroethane (DDT) homologs and their metabolites (p,p'-DDD, o,p'-DDD, p,p'-DDE, p,p'-DDT, o,p'-DDT, o,p'-DDE), sodium pentachlorophenate and PAHs varied from 0.536±0.330 to 6.937±2.655, 14.421±5.260 to 82.871±31.258, 15.346±6.935 to 48.254±16.836, and 33.0±11.5 to 369.1±138.5 µg/kg, respectively. The concentrations of HCH isomers followed the order: γ-HCH>ß-HCH>δ-HCH>α-HCH. The most dominant γ-HCH ranged from 0.253±0.155 to 3.465±1.010 µg/kg, suggesting a recent input of lindane. p,p'-DDD was the most dominant pollutant of DDTs, with a mean concentration of 31.684±13.530 µg/kg. The ratios of (DDE+DDD)/DDT ranged from 75±24 to 360±115, indicating no recent input of DDTs. The PAHs were mainly originated from liquid fossil fuel combustion and leakage, except at Pojiang River estuary, where the pyrogenic source (coal, grass and wood combustion) was dominant. Several PAH metabolites were identified and the possible degradation pathways were proposed.